Novel 3D printed hearts for improved patient outcomes:
Using micro-CT we produced the first time 3D representations of the cardiac conduction system in in-tact normal and congenitally malformed human hearts. This data was then used to create 3D printed hearts showing the cardiac conduction system. These print were the frist of their kind, showing the coloured cardiac conduction system in the setting of a flexible, transparent, cuttable and suturable myocardium. 3D-printing has allowed us to create physical models to aid understanding, teaching, patient consultations and to aid planning and practice of complex surgeries.
New anatomy to validate future clinical screening of heart disease:
We continued to improve the understanding of cardiac microanatomy and its role in 4D pump-function. This provides us with the opportunity to validate the potential use of DTMRI in the clinical assessment of cardiac remodelling and pump dysfunction. DTMRI offers a resolution that is an order of magnitude poorer than micro-CT but still allows analysis of the mean arrangement of myocyte chains and lamellar units. Previously, DT-MRI findings have been ‘validated’ by serial histology; in our view, validating 3D data with a 2D technique is erroneous, especially considering the heterogeneous 3D micro-anatomy. Micro-CT provides high resolution images in which individual myocyte chains are resolved. So far we have provided rudimentary validation of DTMRI for use in assessment of myocardial microstructure in 3D using high resolution tomographic imaging. DTMRI has the potential to be a powerful diagnostic and prognostic tool in the assessment of myocardial remodelling in disease.
Metabolic imaging for early diagnosis of heart failure:
Clinicians desire an objective non-invasive technique to provide high-resolution morphological data, with organ specific regional metabolic assessment. During the development heart failure, disease processes begin at the intracellular level before macro-anatomic pathology can be recognised. Changes in cardiac metabolism therefore offer an attractive diagnostic target. Our study confirms the efficacy of in-vivo [113C]pyruvate MRI imaging for assessment of metabolic impairment in heart failure. In addition, our data suggests morphological and metabolic remodelling are linked, and these data will allow us to answer the important question of whether metabolic remodelling precedes micro-anatomical remodelling.
