“By refining the method for women specifically, we were able to diagnose 16.5pc more females with heart failure,” said lead author Dr Pankaj Garg, of the University of East Anglia’s Norwich Medical School and a consultant cardiologist at the Norfolk and Norwich University Hospital. “This could have huge impact in the NHS, which diagnoses around 200,000 patients with heart failure each year. This improved method will increase early detection, meaning more women can get life-saving treatment sooner.”
“Currently one of the best ways of diagnosing heart failure is to measure pressures inside the heart with a tube called a catheter,” said co-author Dr Gareth Matthews, of the University of East Anglia’s Norwich Medical School. “While this is very accurate, it is an invasive procedure, and therefore carries risks for patients, which limits its use.”
“For this reason, doctors tend to use echocardiograms, which are based on ultrasound, to assess heart function, but this is inaccurate in up to 50 percent of cases. Using MRI, we can get much more accurate images of how the heart is working,” explained Matthews.
When the heart begins to fail it is unable to pump blood out as effectively as it should leading to pressure in the heart increasing. The team was able to create an equation that allowed them to non-invasively derive the pressure within the heart using an MRI scanner. Previously this method wasn’t accurate in diagnosing heart failure in women, especially among those with early or borderline heart disease.
“Women’s hearts are biologically different to men’s,” said co-author Professor Andy Swift, of the University of Sheffield’s School of Medicine and Population Health. “Our work suggests that in heart failure women’s hearts may respond differently in response to increases in pressure.”
Heart failure is classed differently depending on the volume of blood being pumped out of the heart’s main chamber with every beat (heart ejection fraction). Women have been found to disproportionately suffer from a type of heart failure where the blood pumping function of the heart is preserved but the ability of the heart to relax and refill is impaired. Unfortunately, echocardiography is not very effective at diagnosing this type of heart failure, however, the advancement from this study will enable more accurate diagnosis and better treatment for those with this type of heart failure, leading to more lives saved.
“The symptoms of heart failure, like breathlessness and fatigue, can have a devastating effect on patients’ quality of life,” said co-author Dr Peter Swoboda, of the University of Leeds’ Faculty of Medicine and Health. “We are increasingly recognising the importance of early diagnosis and, early treatment can improve symptoms and life expectancy. This research will help diagnose heart failure in women more quickly and get them established on life-saving treatments sooner.”
“Heart failure is a devastating condition affecting hundreds of thousands of women in the UK, so this research is a hugely positive development that could make it possible for thousands of people to get diagnosed and treated at an earlier stage,” said the Government’s Health and Social Care Secretary, Victoria Atkins. “For the second year of our Women’s Health Strategy for England, I have been clear that we need more research to look at the differences between how conditions affect men and women. I am delighted that this government-backed research has met this challenge so that we can get life-saving treatment to women faster.”
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