The Use of Cardiovascular Magnetic Resonance to guide prognosis and clinical management in cardiac valve disease
Quantitative measurement in cardiac valve disease
Our research examines whether an advanced cardiac imaging technique, cardiovascular magnetic resonance (CMR), can improve the clinical management of patients with heart valve disease. The detailed quantitative information available from CMR may be particularly useful in patients who don’t experience symptoms, who currently present a clinical challenge. The ability to predict the onset of symptoms or irreversible cardiac dysfunction would be a major advance, and our research focuses on the prognostic ability of CMR in the 3 main types of cardiac valve disease. If successful, this research could have a major impact on the management of these patients, and help to elucidate the mechanisms of cardiac dysfunction in valve disease.
The physiological effects of ACE inhibitors in asymptomatic aortic stenosis
The potential for drug treatment of a common heart valve condition is being tested in a clinical trial. Patients with aortic stenosis (a narrowing of the main valve out of the heart) can develop a thickened heart muscle and heart failure, both of which are detrimental. A group of drugs called ACE inhibitors may improve the ability of the heart muscle to cope with the valve disease, which might delay the onset of symptoms and the need for heart surgery. We are using advanced imaging (Cardiovascular Magnetic Resonance and 3-dimensional echocardiography) and biochemical markers to determine the physiological effects of the drug on the heart. We hope to identify and improve the mechanisms underlying the progression to heart failure.
The techniques used in CMR are continually improved, particularly focussing on the accurate measurement of high velocity flow jets. New imaging processes are being developed to cope with turbulent flow and irregular heart rhythms.
Dr. Saul Myerson is a consultant cardiologist at the John Radcliffe Hospital in Oxford and a clinical fellow at the University of Oxford Department of Cardiovascular Medicine. He specialises in non-invasive cardiac imaging, particularly cardiovascular magnetic resonance, and his clinical and research interests are in valve disease and cardiomyopathies. He qualified from the University of Bristol and completed further training in London and Oxford. He has published widely, is editor of the Oxford Handbook of Cardiology Emergencies and the Oxford Handbook of Cardiovascular Magnetic Resonance, and was president of the British Junior Cardiologists Association from 2005-2007.