Heart failure unraveled with light and sound
When the heart has to work too hard, for instance when a heart valve is leaking, the heart muscle stiffens and changes composition: muscle cells die and are replaced by scar tissue. Erasmus MC teams up with research ultrasound company FUJIFILM Visualsonics and three Dutch SMEs: Percuros, PanaceAR and Kaminari Medical, to develop a new technology with lasers, ultrasound, and molecular labels that enables early detection of tissue changes.
Approximately 38.000 people in the Netherlands per year are diagnosed with heart failure, and associated healthcare costs are almost 850 million euro per year. Heart failure is often a consequence of a previous heart attack, chronic high blood pressure, or a leaking valve. It is a condition that strongly affects quality of life. With medication and lifestyle changes, the progression of the disease can be slowed down. For this reason, early detection is important.
The changes in the heart that happen on a cellular level are the earliest signs of heart failure. These cannot be detected with technology available today. In this project, we applied molecules that stick to particular sites of scar tissue and necrosis – so-called contrast agents – to make early heart failure visible. Such images can be made with photoacoustics, where light is used to make ultrasound images of organs. The photoacoustic imaging has to be fast enough to prevent motion blur when looking at the moving heart.
PICA-Heart has yielded important insights in mechanisms of heart failure, and in organ quality for transplantation. We discovered that in chronic heart failure, the heart muscle has less oxygen available for its metabolism than a healthy heart (see image). Quantification of oxygen saturation becomes more reliable if we correct for the motion of the heart. We found a similar contrast in kidneys for transplantation, and showed that poorly functioning kidneys had lower blood oxygen levels. Contrast dyes showed necrosis in kidneys. This may become useful for detection of heart failure and for organ selection for transplantation.
