MRI Scan Detects Patients at Risk for Heart Problems

MRI Scan Detects Patients at Risk for Heart Problems 

A new $3.2 million grant from the National Institutes of Health is helping researchers at UVA develop advanced MRI technology to detect heart disease earlier and more accurately. The grant supports human trials that explore how the composition of fat surrounding the heart contributes to heart failure �” a study that could change lives for patients like Debbie Dart. 

Dart has been seeing cardiologist Dr. Amit Patel since 2023. Under his care, Dart found relief for her chest pain, which had puzzled many of her previous doctors. 

“Because of the pain, I wasn’t going anywhere that had any walking. I wouldn’t go on any trips or even craft fairs or anything like that because I knew I couldn’t walk that far,” Dart said. “I wasn’t even able to walk in my front yard a lot of times without having really bad pain.” 

Patel, however, approached Dart with a positive attitude and was able to find treatments that slowly improved her pain. 

“I just feel blessed to have had Dr. Patel because he made a huge difference in my life,” Dart said. 

Along with treating patients, Patel also researches ways to tackle diseases related to the heart. His research impacts the treatment patients receive and, because of this, makes patients like Dart strong supporters of his work. 

“I think what Dr. Patel had already studied when I first went to him impacted the treatment that he proposed to me,” Dart said. “And that made a world of a difference.” 

Now, Dart is excited about the possibility of participating in Patel’s newest research. Working alongside Fred Epstein, the Commonwealth Professor of Biomedical Engineering and Radiology and Medical Imaging, Patel is finding ways to use MRI to predict and treat heart problems by assessing the adipose tissue �” fat �” around the heart. 

“I would love to be a part of this study,” Dart said. “It’s amazing that there can be more tools to work with the symptoms and, actually, the cause of the pain.” 

Dangers of Adipose Tissue 

While some fat around the heart is beneficial, Patel and Epstein’s research shows that an increase in adipose tissue leads to a rise in the percentage of inflammatory saturated fat around the heart. Since there is no barrier between the adipose tissue and the heart, inflammatory proteins can transfer from the saturated fat to the heart’s blood vessels and muscles, leading to heart disease. 

“Heart disease is the number one cause of death in the Western world,” Patel said. “In general, it is extremely common and is the biggest expenditure for health care.” 

While imaging devices such as ultrasounds, CT scans and MRIs have already been used to examine the amount of fat around the heart, Patel and Epstein take a different approach. 

“Instead of looking at the amount of adipose tissue, we use MRI to measure and quantify the composition of the adipose tissue,” Epstein said. “That’s been done before in other adipose tissues, but not around the heart.” 

To accomplish this task, Epstein and his team developed specialized MRI imaging technology that can rapidly assess adipose tissue composition without interference from cardiac or respiratory motion. This new technology will help clinicians better identify which patients are at a greater risk for heart disease. 

Application for Other Diseases 

While Patel and Epstein focus on patients with heart failure, they believe their imaging technology will be important for other types of illnesses as well. 

“Adipose tissue composition may play a role in lots of obesity-related diseases. Obesity is bad for everything from the heart to the brain to the function of other organs,” Epstein said. “Adipose tissue composition is believed to play an important role in cancer as well.” 

Because of this, Epstein’s cardiac MRI may serve to predict, diagnose and treat many diseases, leading to broad applications of the technology. 

While early research with mice has already demonstrated that treatment with certain drugs decreases the amount of saturated fats around the heart, Patel and Epstein are looking to test medications like Ozempic and Wegovy in human trials. 

This research will help clinicians understand why some drugs work better for certain individuals and will help patients make informed health decisions. 

“Some of these medications are expensive and not all patients want to take them,” Patel said. “So, if we had a really strong signal to justify it, you could have better conversations with the patients.” 

Collaboration at UVA 

Patel and Epstein attribute their success to the collaboration culture at UVA. 

“One of the innovations of UVA is that there are always regular research meetings that involve not only the clinical cardiac MRI team, but also the engineers working in MRI,” Patel said. 

These meetings foster dialogue between different departments at UVA and promote interdisciplinary research, which is important when studying cardiac MRI. 

“We need to understand where the opportunities are to make advancements,” Epstein said. “You have to have a really close, ongoing dialogue between cardiologists, engineers and scientists so that we can advance the field through innovations.” 

UVA’s history with cardiac MRI research also serves as a solid foundation for the progression of Patel and Epstein’s studies.

“UVA is one of the world’s premier cardiac MRI centers. Since 2000, it has played an important role in developing new MRI techniques and showing how these techniques can help patients,” Patel said. 

Research That Changes Lives 

So far, Patel has received positive responses from his patients, with many even asking to participate in the study. 

“Some of my patients were asking how they can volunteer to be part of the research,” Patel said. “I think patients are pretty excited about it.” 

Dart, for one, is confident in the potential of the study to change lives. After all, Patel changed hers. 

“If there are other people who have been going through the same issues as me, this study could benefit them so much,” Dart said. 

This work is supported by the National Heart, Lung, and Blood Institute, grant 1R01HL181257-01. The Principal Investigators on the award are Epstein, Frederick H, Patel, Amit R.