Posted on Mar 31, 2023, 2 p.m.
Currently, doctors use measures such as heart chamber size and systolic function to diagnose and monitor cardiomyopathy and other related heart issues, assessing how round the heart is, called cardiac sphericity, may be a new approach to add to the toolbox according to research published in the journal Med.
“Roundness of the heart isn’t necessarily the problem per se — it’s a marker of the problem,” said co-corresponding study author Dr. Shoa Clarke, a preventive cardiologist and an instructor at Stanford University School of Medicine in California.
“People with rounder hearts may have underlying cardiomyopathy or underlying dysfunction with the molecular and cellular functions of the heart muscle. It could be reasonable to ask whether there is any utility in incorporating measurements of sphericity into clinical decision-making,” Clarke suggested.
Heart sphericity was focussed on because clinical experience suggests that it could be associated with heart problems. In the past research has focused on sphericity after the onset of heart disease, but in this study, the researchers hypothesized that it might increase before the onset of clinical heart disease.
“We have established traditional ways of evaluating the heart, which have been important for how we diagnose and treat heart disease,” Clarke said. “Now, with the ability to use deep-learning techniques to look at medical images at scale, we have the opportunity to identify new ways of evaluating the heart that maybe we haven't considered much in the past.”
Data was used from a subset of 38,000 participants who were enrolled in the UK Biobank Study who had MRIs that were considered to be normal at the time taken. Subsequent medical records revealed which participants later developed diseases such as cardiomyopathy, atrial fibrillation, or heart failure and which ones did not. Deep learning machine techniques were used to automate the measurement of sphericity, findings showed that increased heart sphericity appeared to be linked to future heart issues. Additionally, further investigation looking at the genetic drivers for cardiac sphericity found an overlap with the genetic drivers for cardiomyopathy.
“They say a picture is worth a thousand words, and we show that this is very true for medical imaging,” said co-corresponding author Dr. David Ouyang, a cardiologist and researcher at the Smidt Heart Institute of Cedars-Sinai, in Los Angeles.
“There's a lot more information available than what physicians are currently using. And just as we’ve previously known that a bigger heart isn’t always better, we’re learning that a rounder heart is also not better,” Ouyang said in a journal news release.
“There are two ways that these findings could add value,” Ouyang noted. “First, they might allow physicians to gain greater clinical intuition on how patients are likely to do at a very rapid glance. In the broader picture, this research suggests there are probably many useful measurements that clinicians still don’t understand or haven’t discovered. We hope to identify other ways to use imaging to help us predict what will happen next.”
The authors noted that more research is needed before the findings from this study can be fully translated into clinical practice, but they are sharing all of the data from this study so that other investigators can also begin studying heart roundness as a risk factor for heart disease.
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