Clinical Studies
Interpretation of pre-morbid cardiac 3T MRI findings in overweight and hypertensive young adults
Gert JH Snel, Riemer HJA Slart, Birgitta K Velthuis, Maaike van den Boomen, Christopher T Nguyen, David E Sosnovik, Vincent M van Deursen, Rudi AJO Dierckx, Ronald JH Borra, Niek HJ Prakken
This study found that young adults who are overweight or have high blood pressure may already be experiencing heart changes similar to those seen in older adults with heart disease. Specifically, the study observed that heart muscle mass increases in these young adults, even though their overall heart size remains similar to those of normal-weight individuals.
A key finding of the study is that the standard method of adjusting heart measurements for body size (using body surface area or BSA) can mask these important changes, especially in overweight individuals. When BSA was used, it made the heart muscle mass appear normal in overweight people, potentially hiding early signs of heart disease. Additionally, BSA adjustment exaggerated the decrease in heart size, which wasn’t accurate. The study suggests that adjusting measurements based on height provides a more accurate picture.
Impact and Clinical Relevance:
This study emphasizes the importance of accurately assessing heart health in young adults who are overweight or have high blood pressure. By highlighting the limitations of the current standard measurement method (BSA), the research suggests that height-based adjustments are more reliable. Clinically, this means that doctors should consider using height-based measurements to better detect early signs of heart disease in these at-risk young adults, allowing for earlier and more effective intervention.
Cardiac Alterations on 3T MRI in Young Adults With Sedentary Lifestyle-Related Risk Factors
Gert JH Snel, Maaike van den Boomen, Katia Hurtado-Ortiz, Riemer HJA Slart, Vincent M van Deursen, Christopher T Nguyen, David E Sosnovik, Rudi AJO Dierckx, Birgitta K Velthuis, Ronald JH Borra, Niek HJ Prakken
This study explored how being overweight, having high blood pressure, and having type 2 diabetes (T2D) affect the hearts of young adults aged 18-45 who do not show symptoms of heart disease but lead a sedentary lifestyle. These risk factors are increasingly common and can cause early changes in the heart that might resemble those seen in more serious heart conditions. The study involved 311 young adults who underwent advanced heart imaging (3T cardiac MRI). Among them, 220 had one or more of the risk factors, while 91 were free of these risks.
Overweight:
A higher body mass index (BMI) was associated with increased heart muscle mass, larger heart chambers, and a greater amount of blood pumped with each heartbeat. It also caused changes in the heart tissue, including an increase in native T1 values and a decrease in extracellular volume (ECV), both of which suggest early remodeling of the heart.
Hypertension (High Blood Pressure):
Higher systolic blood pressure was linked to an increase in heart muscle mass and a higher left ventricular ejection fraction (EF), which means the heart is pumping a higher percentage of blood with each beat. In contrast, higher diastolic blood pressure was associated with a lower EF, indicating a reduced efficiency in heart function.
Type 2 Diabetes (T2D):
Higher levels of HbA1c, a marker of long-term blood sugar control, were associated with increased heart muscle mass, larger right heart chambers, and higher ECV, which could be a sign of early heart damage.
Additionally, a faster heart rate was linked to decreased heart muscle mass, smaller heart chambers, and lower T2 values, indicating possible tissue changes.
Impact and Clinical Relevance:
The study reveals that young adults with these risk factors—overweight, hypertension, and T2D—are already showing subtle, yet significant, changes in heart structure and function, even if they are not experiencing symptoms. This highlights the increased risk of future heart disease in this population.
Clinical Application:
In clinical practice, these findings suggest that when doctors use cardiac MRI to assess young patients with these risk factors, they should pay close attention to these early changes. For instance, recognizing an increased ejection fraction due to high systolic blood pressure or a decreased ejection fraction linked to high diastolic blood pressure can provide early warning signs of developing heart issues. By identifying these changes early, healthcare providers can intervene sooner, potentially preventing the progression to more serious heart disease.
DeepStrain Evidence of Asymptomatic Left Ventricular Diastolic and Systolic Dysfunction in Young Adults With Cardiac Risk Factors
Manuel A Morales , Gert JH Snel, Maaike van den Boomen, Ronald JH Borra, Vincent M van Deursen, Riemer HJA Slart, David Izquierdo-Garcia, Niek HJ Prakken, Ciprian Catana
This study aimed to determine if a fully-automatic tool called DeepStrain can detect early heart problems in young adults with risk factors like being overweight, having high blood pressure, or type 2 diabetes, even if they don’t have symptoms. DeepStrain uses advanced algorithms to analyze MRI images of the heart. We tested this tool on MRI scans from both healthy individuals and those with heart disease. We then recruited 119 young adults aged 18-45 and grouped them based on their risk factors: Group 1: Overweight but without high blood pressure or type 2 diabetes. Group 2: High blood pressure but without type 2 diabetes. Group 3: Type 2 diabetes, regardless of other conditions. All participants had an MRI of their heart, and DeepStrain measured heart function. We compared these measurements between the different risk factor groups and healthy controls.
The study showed that despite similar heart size and pumping efficiency across all groups, those with risk factors had early signs of heart dysfunction. They had lower heart strain measurements during both the filling and pumping phases compared to healthy controls. Factors such as body size and blood pressure were linked to these changes. DeepStrain successfully detected early signs of heart dysfunction in asymptomatic young adults with risk factors like being overweight, high blood pressure, or type 2 diabetes.
Impact and Clinical Relevance:
This study highlights that DeepStrain can be a valuable tool for early detection of heart issues in young adults with risk factors. By identifying subtle signs of heart dysfunction before symptoms appear, doctors can implement preventive measures sooner. This early intervention can help prevent the development of more serious heart conditions, improving long-term heart health and reducing the risk of future heart disease.