King's doctor wins award for heart failure research

07 December 2018 - Dr Dan Bromage wins the British Society of Heart Failure's Young Investigators' Award

Dan Bromage

A doctor at King’s College Hospital has been recognised for his research, which could lead to better treatments for patients with heart failure.

Dr Dan Bromage, a specialty trainee in heart failure, has won the Young Investigators' Award from the British Society for Heart Failure for his research which compared data from two different types of patient heart scans.

Currently patients with heart failure are given an echocardiogram (often called an echo), which uses sound waves to create an image of the heart. The reading from the echo is used to determine whether the patient has a problem with the pumping function of the heart when it beats and how severe this problem is. However, the echo reading has a 10% margin of error.

In contrast, doctors can get a much more reliable reading if they use magnetic resonance imaging (MRIs), which uses strong magnetic fields and radiowaves to build up a detailed image of the heart.

Research on heart drugs carried out over a number of decades all relies on data taken from echocardiograms, which is why doctors continue to use them despite the availability of newer techniques.

However, this 10% margin of error is particularly problematic for those patients who have a less severe problem with the movement of their heart – these are known as the ‘mid-range’ patients. Dr Bromage said his analysis demonstrated that around 80% of patients who were previously thought to be in the mid-range on echo actually have normal pumping function using MRI.

Previous clinical trials have shown that drugs for patients in the mid-range are not effective. But Dr Bromage believes those trial results should be interpreted with caution because many of those patients may have normal pumping function and therefore be less likely to benefit from treatment.

His work involves comparing echo and MRI readings of patients, and using the data to determine what MRI readings could be used to indicate a severe problem with heart function and what would be a mid-range reading. He hopes that, in the future, MRI could be used to investigate whether heart failure drugs might be beneficial in patients who are truly in the mid-range.

Dr Bromage said: “I am delighted to have won this award. This is important work because there may be patients in the mid-range who are not currently being prescribed drugs that may be beneficial to them. Larger studies are necessary to test this hypothesis, but it could mean cardiologists across the NHS will start to use MRIs as standard practice, especially for patients in the mid-range, which may enable more accurate assessment of the heart's pumping function and potentially better outcomes for patients.

“King’s is a leading centre for heart failure and it was thanks to the facilities and expertise we have here, as well as the large number of patients we treat, that I was able to carry out this work.”


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