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The William Harvey Research Institute - Faculty of Medicine and Dentistry

New cardiac research will save women’s lives by improving detection of heart failure

An important new study involving researchers from Queen Mary University of London has advanced how heart failure is detected in women – meaning more female patients can be diagnosed at an earlier stage. 


MRI scan of the heart.

Researchers led by teams from the Universities of East Anglia (UEA), Sheffield and Leeds, have been able to fine-tune how magnetic resonance imaging (MRI) is used to detect heart failure in women’s hearts, making it more accurate. 

Lead author Dr Pankaj Garg, from the University of East Anglia’s Norwich Medical School and a consultant cardiologist at the Norfolk and Norwich University Hospital, said: “By refining the method for women specifically, we were able to diagnose 16.5% more females with heart failure. 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."    

In 2022, UEA and the University of Sheffield published research which showed how using MRI scans could be used to detect heart failure and which led to this technique being widely employed by medics. 
When a heart starts to fail, it is unable to pump blood out effectively, and so the pressure in the heart rises. The team was able to create an equation which allowed them to non-invasively derive the pressure in the heart using an MRI scanner.  

Study contributor Dr Nay Aung, from Queen Mary University of London, and a consultant cardiologist at Barts Health NHS Trust, said: “Assessment of raised filling pressure in the heart is critical in diagnosing heart failure. In cases with diagnostic uncertainty, an invasive procedure called right heart catheterisation is required to directly measure the heart pressures. This study provides mathematical equations for men and women to estimate heart filling pressure using non-invasive cardiac MRI measurements. Our study demonstrates that these equation-based estimates are accurate when benchmarked against invasive pressure measures. The non-invasive pressure estimates also strongly predict adverse outcomes paving way towards routine clinical implementation."
Previous use of this method wasn’t as accurate as the researchers would have liked in diagnosing heart failure in women, especially in early or borderline disease. 

Co-author Professor Andy Swift, from University of Sheffield’s School of Medicine and Population Health, said: “Women’s hearts are biologically different to men’s. Our work suggests that in heart failure women's hearts may respond differently in response to increases in pressure.”
Heart failure can be classed differently, depending on the amount of blood squeezed out of the main chamber of the heart with every beat, known as the heart’s ejection fraction. 
Women suffer disproportionately from a type of heart failure where the pumping function of the heart is preserved but the ability of the heart to relax and fill with blood is impaired.  
Echocardiography struggles to diagnose this type of heart failure. The improvements in diagnosis from this new study will enable more women to be diagnosed accurately and hopefully drive better treatments. 

The Government’s Health and Social Care Secretary, Victoria Atkins, said: "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. 
“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." 
The research was a collaboration between the University of East Anglia, the University of Leeds, the University of Sheffield, the Norfolk and Norwich University Hospital NHS Foundation Trust, the National Heart Research Institute Singapore, Duke-NUS Medical School in Singapore, Queen Mary University of London, the National Institute for Health and Care Research’s Sheffield Biomedical Research Centre, the University of Amsterdam and Kocaeli City Hospital in Turkey. 
It was funded by the National Institute for Health and Care Research (NIHR) Sheffield  
Biomedical Research Centre, the Wellcome Trust, and the National Medical Research Council (NMRC).  
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