Cardiac analysis "may reveal signs of risk of sudden death"



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Fabrice Muamba

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Fabrice Muamba collapsed while he was playing for Bolton Wanderers in 2012

Scientists say that a new analytical technique could identify people at risk of collapsing and dying suddenly from hidden heart disease.

Normally, in people with hypertrophic cardiomyopathy, signs of structural changes in the heart can only be detected after death.

But researchers at Oxford University have used microscopic imaging to detect the same trends in living patients.

This disease is the leading cause of sudden cardiac death in young people.

It is a common hereditary condition that affects one in 500 people in the UK and can be fatal in a small number of people.

Footballer Fabrice Muamba had an almost fatal heart attack during a match. David Frost's son, Miles, died suddenly while jogging at the age of 31, for example.

Yet many people with hypertrophic cardiomyopathy, or HCM, have few if any precursor symptoms – and some are able to lead a perfectly normal life.

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The research team focused on detecting people at risk for sudden death by looking for abnormal fiber structures in the heart that could lead to life-threatening heart rhythms.

It is thought to affect about 1% of sufferers.

They can then have a small implanted device in their heart to put it back to beat as soon as an abnormal heart rhythm is detected.

Dr. Rina Ariga, author of the study and cardiologist at Oxford University, said: "We hope that this new scanner will improve the way we identify high-risk patients, so that 39, they can receive an implantable cardiac defibrillator early to prevent sudden death. "

She added, "We must now work to make this analysis shorter and faster for patients to test its utility in a large multicentre study."

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Dr. Rina Ariga

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An almost complete ring of muscle fibers in a normal heart (yellow on the left) is broken or missing in a heart with MHC due to a fiber disorder

Currently, the calculation of a patient's risk is based on the thickness of his or her heart wall, family history, as well as on any unexplained collapses and abnormal heart rhythms.

The difference with the Oxford researchers' approach lies in the fact that they used MRI scans to examine detailed images of the structure of the heart muscle to detect a "muscle fiber disorder" .

This suggests that the heartbeat is not allowed to spread evenly over the muscle fibers of the heart.

The study, published in the journal of the American College of Cardiology, digitized 50 MHC patients and 30 healthy volunteers and was able to see a "disturbance" in living patients with heart disease who 39, had been previously discovered only in patients after sudden cardiac death.

These patients were also more likely to have an abnormal heart rhythm.

The technique, called diffusion tensor magnetic resonance imaging, is normally used on the brain – but thanks to the progress it has made, it can now be used on the heart.

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Dr. Steven Cox, Executive Director of the Cardiac Risk in the Young Charitable Foundation, said, "It is fantastic to think that these clinical findings could be identified in patients living with HCM and used for routine diagnosis and treatment. . "

Dr. Cox said that the key to identifying people at risk in the general population was heart screening "using a cost-effective, non-invasive ECG. [electrocardiogram] test".

It is possible to book for those under 35 through the organization's Test My Heart website.

Professor Metin Avkiran, Associate Medical Director of the British Heart Foundation, who helped fund the research, said: "Although further work is needed to refine and test this review, its potential benefits for HCM patients are huge.

"This work is an excellent example of cutting-edge, research-based technology that could change the way we diagnose and treat heart and circulatory diseases."

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