8 Jan 18. Transatlantic research to improve heart disease treatment
Dr Marc Dweck spent a year in New York developing advanced ways to spot and treat heart problems, hear how.
As a BHF-funded researcher, Dr Marc Dweck, Senior Lecturer and Consultant Cardiologist at the University of Edinburgh , was fortunate to receive funding from the BHF, to spend a year in New York, working with world-leading experts in scanning the heart and the arteries.
“I wanted to work with Dr Valentin Fuster, based at Mount Sinai Hospital in New York,” says Dr Dweck. “He is one of the top cardiologists in the world and I wanted to see how he runs his clinical and research teams. I was working under Dr Zahi Fayad, Director of the Translational and Molecular Imaging Institute at Mount Sinai. He is an inspirational and charismatic guy who has pioneered the latest cutting-edge imaging techniques to look at heart disease.”
It often meant meetings at 5am or late at night, but Dr Dweck says it was worth it. “Those guys are really busy, effective people, and I had to get up early in the morning to try to meet them,” he says. “They have a fantastic work ethic and I was grateful to spend some time with them.”
As well as learning from the best people, he had a chance to use the best equipment.
I was using a state-of-the-art scanner - the idea was that I would go out there to learn how to use the scanner, and then bring that knowledge back. We now have one installed in Edinburgh and I’ve started to use it here, based on my learnings from New York. There is a whole programme of research into heart disease that is using this new machine.
Using scanners for detailed study
The multi-million-pound scanner – one of the most complex machines of its kind – is a PET-MRI scanner. This stands for positron emission tomography (PET) combined with magnetic resonance imaging (MRI). PET means that scientists can look at processes inside the human body, at a molecular level, while MRI can show fine detail in body tissues.
In his work in New York, Dr Dweck was studying the heart muscles, trying to use scans to see disease-causing processes within the molecules inside our cells – processes far too small to see with the human eye.
This could help diagnose rare types of heart failure, including cardiac amyloidosis, which can be fatal without treatment. “These are quite rare conditions that are difficult to diagnose, and need a number of different tests to diagnose them,” explains Dr Dweck. “PET-MRI seems to give you all the information that you need in a single test.”
The Edinburgh Imaging Facility QMRI, has a Siemens Biograph mMR system; the first of its kind in Scotland.
The expertise Mark has gained in PET is now being used in a BHF-funded trial at the University of Edinburgh. The trial will test the effects of two drugs on aortic stenosis – the most common type of heart valve disease, in which the aortic valve in your heart becomes stiff and narrow, so the heart struggles to pump blood. The only cure is surgery to replace the valve. The scanner will allow researchers to see what effects the drugs have on the valve.
Another focus of Dr Dweck’s research is the fatty plaques that build up in arteries, especially as we get older. If one of these ruptures, it can cause a heart attack or stroke. Dr Dweck has spent years working on ways to spot plaques likely to rupture, so we can identify and treat high-risk patients. This has been done with a combination of PET and CT (another type of scan), but during his stay in New York, Dr Dweck and colleagues established that PET-MRI is another way to do this. He also studied plaques in the neck arteries, to try to predict risk of stroke. Since returning to Edinburgh last year, he’s been working on another trial to improve the prediction of heart attacks, by scanning plaques in the arteries.
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