Rapid heart imaging system may improve care in developing nations

A rapid imaging system could improve heart healthcare in developing nations because of reduced costs and easier availability, according to a study in Peru.

Researchers found in a study in Peru that a new rapid method of imaging can improve heart care and reduce costs for screening. Photo courtesy of the American Heart Association
Researchers found in a study in Peru that a new rapid method of imaging can improve heart care and reduce costs for screening. Photo courtesy of the American Heart Association

Researchers determined the new system, which uses contrast dye to measure cardiac structure, function and scarring, was effective at a fraction of the costs and time required for the traditional imaging system. The findings were published Wednesday in the Journal of the American Heart Association.
In Peru, 16 percent of the population has cardiovascular disease, researchers say, but screening people there for heart conditions can be difficult.

The Cardiac Magnetic Resonance Imaging system, also called cardiac MRIs, are often not available for people in Peru and other developing nations. The method provides detailed information on the type and severity of heart disease using radio waves, magnets and a computer.

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Researchers say the new method of three to five times cheaper than current exams in Peru, and the screening was easier and at least twice as fast as the standard method.

“Because the rapid CMR protocol was embedded in clinical care with training and education, it resulted in important and frequent patient management changes that appeared beneficial for both patients and the healthcare system,” first author Dr. Katia Menacho, a cardiovascular science research fellow at Barts Heart Center in St. Bartholomew’s Hospital in London, said in a press release. “Lack of resources is not a justification for the absence of key diagnostic tests in the developing world.”

In a study of 98 Peruvian patients with an average age 52, scans uncovered a variety of conditions. Rapid diagnostics, working with existing infrastructure, took 18 minutes and cost $150 per patient, the researchers said. The traditional method takes 45 minutes and is around $400 to $800 in the studied areas.

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Twenty-six percent had hypertrophic cardiomyopathy, which is condition in which the heart muscle becomes abnormally thick. That was followed by 22 percent with dilated cardiomyopathy, where the heart’s ability to pump blood is decreased because the heart’s main pumping chamber, the left ventricle, is enlarged and weakened. Also, 15 percent were diagnosed with ischemic cardiomyopathy, which occurs when cardiovascular disease or heart attack cause the disease.

In addition to the top three conditions, the researchers also uncovered were tumors, congenital heart disease, iron overload, abnormal protein deposits, genetic syndromes, inflamed vessels, clots and valve disease.

Using CMR, researchers found an unsuspected diagnosis in 19 percent of patients or altered treatment based on the method in 37 percent of patients.

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CMR revealed an unsuspected new diagnosis in 19 percent of patients or a change of treatment in 37 percent of patients. A change in care management was suggested on 5 percent of scans but not delivered due to access barriers, including cardiac surgery or device therapy.

The rapid technique satisfied all imaging needs in 89 percent of patients, and no further non-invasive imaging was needed in 7 percent where CMR was the first imaging technique performed.

CMR did not miss any diagnoses initially found by echocardiography, the researchers said.

“To make this proof-of-principle study a reality in much of the developing world, much work is ahead to train imagers at sites with appropriate scanner technology,” Dr. Christopher M. Kramer, of the University of Virginia Health System in Charlottesville, wrote in an accompanying editorial. “Only in this way will an abbreviated protocol for evaluation of cardiomyopathies be implemented. This is an exciting time for the potential of broadening the impact of CMR throughout the developing world.”

ByAllen Cone