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Researchers find new way to predict risk of death in heart patients

3T MRI scanner in the Cardiovascular BRU

6 March 2013

Experts from Royal Brompton Hospital and Imperial College London today publish research showing that scarring (fibrosis) of the heart is an accurate predictor for sudden cardiac death for patients with dilated cardiomyopathy (DCM). Fibrosis, which can be detected through a cardiovascular magnetic resonance (CMR) scan, is shown to be a better predictor of death than measures used currently and could potentially result in a 30 per cent cost saving for the NHS.

Lord Howe, Health Minister, praised the research saying: “We want our patients to have access to the most effective treatments possible, especially if that treatment could help to save their lives. Research like this is incredibly important and I’m delighted we could support the work of clinicians at Royal Brompton Hospital through the National Institute for Health Research.”

DCM, a disease that weakens and enlarges the heart, preventing it from pumping properly, affects more than 35,000 people in the UK and is a leading cause of heart failure. Although some patients benefit from an implanted cardioverter defibrillator device (ICD) to prevent death from DCM, this does not work for all patients, and it is an expensive form of treatment, with unpredictable results.

Researchers, who studied more than 470 DCM patients over eight years, found that fibrosis, which can be detected through a cardiovascular magnetic resonance (CMR) scan, is a better predictor of death than measures used currently. Their paper is published in the prestigious Journal of the American Medical Association (JAMA).

Professor Dudley Pennell, consultant cardiologist at Royal Brompton, director of the NIHR Royal Brompton Cardiovascular Biomedical Research Unit and professor of cardiology at Imperial College, said: “Implantable defibrillators can be an effective treatment to prevent risk of sudden death, but we need much more evidence to know which patients would benefit.

“Our findings mean we can improve the selection of patients to have a device fitted – saving lives and potentially, 30 per cent in costs to the NHS.”

Detecting scarring of the heart muscle through CMR scans for each patient provides essential information making it far easier for clinicians to decide which patients will benefit most from having an ICD inserted.

The lead author on the JAMA paper, Dr Sanjay Prasad, Royal Brompton cardiologist and senior lecturer at Imperial College, said: “Our findings fill an important and significant gap in clinical knowledge about treating dilated cardiomyopathy.”

Lord Howe added: “Their work will ensure that patients get the most appropriate treatment, directly saving and improving lives, and help NHS funds to be used most effectively.”

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