The State University of Campinas (UNICAMP) research intern Andréa Coy-Canguçu received the Early Career Travel Grant awarded by the Council on Cardiovascular Radiology and Intervention (CVRI) at the American Heart Association (AHA) Scientific Sessions 2022, which took place in Chicago between November 5th and 7th. Coy-Canguçu presented the study ‘Multiparametric CMR Tissue Characterization Distinguishes Pathological From Physiological Hypertrophy and Correlates With CPET Findings’, which was performed under the direct mentorship of Otávio Rizzi Coelho-Filho, MD, PhD, Associate Professor of Medicine at the UNICAMP School of Medical Sciences, Department of Cardiology.

“The heart can undergo enlargement – a condition termed cardiac hypertrophy – in the setting of either pathological or physiological triggers, such as exercise”, says Coelho-Filho. “While physiological hypertrophy is reversible and does not cause any harmful changes to cardiac function, pathological hypertrophy can eventually progress to heart failure if left untreated. This is why it is so important to distinguish between these two types of hypertrophy, and cardiac magnetic resonance (CMR) imaging can help us do just that”.

The investigators enrolled eighty-eight patients with heart failure who were under follow-up in the heart failure outpatient clinic of the UNICAMP Clinical Hospital and compared them with forty-three athletes and forty healthy volunteers. With the use of multiparametric CMR techniques, including native T1, extracellular volume fraction, and intracellular lifetime of water, which can detect the presence of fibrosis in the heart and an increase in the size of cardiomyocytes, the investigators were able to verify that patients with heart failure did indeed have evidence of pathological hypertrophy, while athletes presented a mildly enlarged heart with no pathological signs. The investigators also noticed that the pattern of hypertrophy varied between the two major phenotypes of heart failure: reduced ejection fraction and preserved ejection fraction.

“Our results demonstrate how valuable a tool CMR can be in differentiating physiological from pathological hypertrophy. This means that when a patient who, say, enjoys running marathons comes in to get a CMR scan and has an enlarged heart but with the pathological signs we have seen in our heart failure subgroup, a red flag will be raised”, explains Coelho-Filho.