Imaging heart. UK Biobank Annual Meeting 13 th June 2016
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1 NIHR Barts and The London Cardiovascular Biomedical Research Unit National Institute for Health Research Cardiovascular Biomedical Research Unit at Barts Imaging heart UK Biobank Annual Meeting 13 th June 2016 Steffen E Petersen, MD DPHIL MPH FRCP FACC FESC s.e.petersen@qmul.ac.uk
2 Disclosures Consultancy, Circle Cardiovascular Imaging Inc., Calgary, Canada Consultancy, GSK This research has been conducted using the UK Biobank Resource. Access application 2964 (PI Petersen).
3 UK Biobank imaging
4 Population based studies (large scale) using CMR Petersen SE et al. JCMR 2013
5 UK Biobank Part of Comprehensive imaging enhancement visit: CMR, abdominal MRI, brain MRI, 3D Carotid US, DEXA + repeat baseline and 12 lead ECG (~3hrs 30min) Target 100,000 participants of 500,000 UK Biobank cohort 20 minutes for CMR Safety: no contrast, no stressor n=9411 (10/06/2016)
6 20 min UK Biobank CMR protocol Copyright UK Biobank SSFP cines 3 long axes Atrial volumes and function LV/RV short axis stack LV/RV volumes and function Tagging (basal, mid and apical short axis, grid) Systolic and diastolic strain Native T1 mapping LV tissue characterisation (fibrosis, scar) Aortic valve flow Aortic valve function Aortic distensibility (level of pulmonary artery/trunk) Vascular function
7 UK Biobank imaging
8 CMR analysis core labs Oxford London BHF Project grant PG/14/89/31194
9 Creation of CMR reference standard LV and RV contours End-Diastole End-Systole Copyright UK Biobank
10 Creation of CMR reference standard LA and RA contours End-Diastole End-Systole Copyright UK Biobank
11 CMR data analysis in UK Biobank Tested in pilot phase as part of QC Analysis of first 5000 CMR scans funded by British Heart Foundation Cross-disciplinary consortium established (first meeting 8/14 at Wellcome Trust) Cardiac imaging analysis consortium established Necessity and opportunity to develop robust automated image analysis algorithms, machine learning etc. Courtesy of Alistair Young, Auckland
12 Normal ranges left and right ventricle Ventricular measurements adjusted by BSA in men Age Groups LVEDV (mean) LVEDV (95% CI) LVESV (mean) LVESV (95% CI) LVSV (mean) LVSV (95% CI) LVM (mean) LVM (95% CI) LVEF (mean) LVEF (95% CI) RVEDV (mean) RVEDV (95% CI) RVESV (mean) RVESV (95% CI) RVSV (mean) RVSV (95% CI) RVEF (mean) RVEF (95% CI) Ventricular measurements adjusted by BSA in women Age Groups LVEDV (mean) LVEDV (95% CI) LVESV (mean) LVESV (95% CI) LVSV (mean) LVSV (95% CI) LVM (mean) LVM (95% CI) LVEF (mean) LVEF (95% CI) RVEDV (mean) RVEDV (95% CI) RVESV (mean) RVESV (95% CI) RVSV (mean) RVSV (95% CI) RVEF (mean) RVEF (95% CI) The unit of all volumetric measurements is ml/m 2 EF in percentage Unpublished data
13 Normal ranges left and right atrium Atrial measurements adjusted by BSA in men Age Groups Maximal LA volume (mean) Maximal LA volume (95% CI) Minimal LA volume (mean) Minimal LA volume (95% CI) LA stroke volume (mean) LA stroke volume (95% CI) LA EF (mean) LA EF (95% CI) Maximal RA volume (mean) Maximal RA volume (95% CI) Minimal RA volume (mean) Minimal RA volume (95% CI) RA stroke volume (mean) RA stroke volume (95% CI) RA EF (mean) RA EF (95% CI) Atrial measurements adjusted by BSA in women Age Groups Maximal LA volume (mean) Maximal LA volume (95% CI) Minimal LA volume (mean) Minimal LA volume (95% CI) LA stroke volume (mean) LA stroke volume (95% CI) LA EF (mean) LA EF (95% CI) Maximal RA volume (mean) Maximal RA volume (95% CI) Minimal RA volume (mean) Minimal RA volume (95% CI) RA stroke volume (mean) RA stroke volume (95% CI) RA EF (mean) RA EF (95% CI) The unit of all volumetric measurements is ml/m 2 EF in percentage Unpublished data
14 Normal range of indexed LV mass Unpublished data
15 Inter- and Intra-observer variability [measured by intraclass correlation coefficient] Ventricular measurement LVEDV LVESV LV mass RVEDV RVESV Inter-observer variability Intra-observer variability Unpublished data
16 Blood pressure medications modify the effect of systolic blood pressure on indexed LV mass Unpublished data
17 Effects of age and gender on blood pressure - LV mass relationship Unpublished data
18 Summary Largest prospective study to date with imaging of the heart using MRI Analysis of heart images is a challenge but UK Biobank provides a great opportunity to advance this field Collaborations forming amongst national and international academics and industry Palpable enthusiasm in heart imaging community
19 UK Biobank: Cardiovascular Imaging Implementation Team (before dedicated staff recruited) UK Biobank Principal Investigator & CEO Rory Collins UK Biobank Imaging Enhancements Chairman Paul Matthews, Imperial College London Cardiovascular Imaging Steffen Petersen, QMUL (CMR Co-lead) Stefan Neubauer, Oxford (CMR Co-lead) Paul Leeson, Oxford (Carotid ultrasound lead) Jane Francis, Oxford (radiographer) Stefan Piechnik, Oxford (T1 mapping, image analysis) Alistair Young, Auckland (image analysis) International UK Biobank Cardiac Imaging Advisory Panel
20 Thank you UK Biobank participants Funders
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