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Centenary Institute - Medical Research
Centenary Institute - Medical Research

Concealed cardiomyopathies revealed in cardiac arrest survivors

Centenary Institute researchers have discovered that genetic testing can identify ‘concealed cardiomyopathies’ in nearly a quarter of sudden cardiac arrest (SCA) survivors who seem to have a normal heart.

The findings will mean improved diagnosis rates and personalised care for SCA survivors as well as guide the screening of family members who may have the same underlying genetic condition.

The study, reported in the ‘International Journal of Cardiology’, undertook genetic testing and analysis of clinically-idiopathic SCA survivors (individuals where previous clinical investigations had failed to reveal a diagnosis).

The researchers identified a genetic cause of arrest in 22% of the SCA survivors studied. The majority of these newly identified cases had genetic abnormalities associated with cardiomyopathy.

“Cardiomyopathies are diseases of heart muscle. They can impair the heart’s ability to pump blood around the body, leading to heart failure but can also cause electrical changes which can lead to dangerous heart rhythms,” said lead author of the study, Dr Julia Isbister from the Centenary Institute’s Agnes Ginges Centre for Molecular Cardiology.

“These conditions are usually detected on clinical tests such as ultrasound but our findings show that state-of-the-art genetic testing may be useful in revealing cardiomyopathy before structural abnormalities are evident.”

Dr Isbister says that identifying the reason for a SCA is critical for both patients and their families.

“If the specific disease can be diagnosed we are better able to implement personalised care for the survivor. If we discover that the SCA is genetically-based we can then screen family members for similar issues. Screening of first-degree relatives is an extremely important aspect of caring for SCA families, aiming to reduce the risk of further cardiac arrests in the family,” said Dr Isbister.

Professor Christopher Semsarian AM, Head of the Centenary Institute’s Agnes Ginges Centre for Molecular Cardiology and senior author on the study says that the role of genetic testing in the management of SCA survivors requires reappraisal given the results of the team’s findings.

“Current guidelines recommend only limited genetic testing of SCA survivors when a specific genetic condition is already suspected. Genetic testing is not generally recommended for those survivors classified as clinically ‘unknown’,” he said.

“Our study has shown that advances in genetic testing technology and analysis can improve diagnosis rates by revealing heart defects that were previously hidden. A reassessment of guidelines and increased genetic testing may lead to better outcomes for survivors, their families and overall prevention of sudden cardiac death in the young.”

Publication: “Concealed cardiomyopathy” as a cause of previously unexplained sudden cardiac arrest.

Precision medicine: can it live up to the hype?

World-renowned health and medical experts, including Prof Chris Semsarian (Head of the Centenary Institute’s Molecular Cardiology Program) came together at the University of Sydney to explore some of the key issues surrounding precision medicine.

In a thought-provoking panel discussion, issues on disease prediction, economics, ethics, clinical applications and the balance between the personal and the public benefit took place.

Listen now or available for download from the Radio National ‘Big Ideas’ website.

Centenary researchers receive cardiovascular disease grants totalling $2.25m

Three Centenary Institute researchers based in Sydney have been awarded grants totalling $2.25m that will help support the diagnosis, treatment and prevention of cardiovascular disease.

The highly competitive grants, from the first round of the NSW Cardiovascular Disease Research Capacity Building Program, were awarded to Centenary Institute’s Professor Christopher Semsarian (left), Professor Jennifer Gamble and Dr Richard Bagnall (right).

Professor Christopher Semsarian, awarded a ‘Cardiovascular Disease Clinician Scientist Grant’ was happy to receive the funding, noting that the grant would support his research into identifying new genetic causes of inherited heart diseases, including that of sudden cardiac death (SCD) in the young.

“We want to find the underlying molecular mechanisms responsible for these life-threatening heart diseases, to provide answers to families as to why their child died suddenly and how can we help prevent these inherited heart diseases from claiming other family members as well as individuals from across the wider community,” he said.

Professor Jennifer Gamble, who was awarded a ‘Cardiovascular Disease Senior Scientist Grant’ will use her funding to explore molecular changes in endothelial cells as they undergo cellular ageing.

“Endothelial cells line blood vessels and changes in their function and structure can result in leaky blood vessels and a chronic inflammatory state,” said Prof Gamble. “These changes contribute to the initiation and progression of age-associated disease including cardiovascular disease. We need to find out what’s happening with these cells at a deeper level as an essential first step to developing potential new therapeutics.”

Dr Richard Bagnall who also received a ‘Cardiovascular Disease Senior Scientist Grant’, will use the funding to support his molecular biology and bioinformatics work into developing improved genetic testing for inherited heart diseases.

“High volumes of DNA sequencing data can now be generated, but it requires sophisticated software and computers to make sense of all that information,” said Dr Bagnall. “I’ll be undertaking a computational analysis of gene sequencing, followed up by laboratory analysis, so that we can precisely identify specific cardiovascular diseases, aiding future diagnostic and treatment approaches.”

Read the full media release here.

NSW Health Article: Professor Chris Semsarian

Professor Chris Semsarian, Head of Centenary Institute’s ‘Molecular Cardiology Program’ is featured in a NSW Health article. It highlights the advanced work that is being undertaken by researchers to better understand the heart and to treat cardiovascular disease.

Work by Professor Semsarian has shown that sudden cardiac deaths in young people are often due to genetic or inherited defects. His focus is on using genetic information to improve diagnosis, to initiate prevention and treatment strategies early in life and to help improve prognosis.

You can read more about Professor Semsarian, what inspires him as well as activities from other leading cardiologists here: https://www.medicalresearch.nsw.gov.au/scientists-solving-mysteries-of-the-heart/

Study reveals technology role in over-diagnosis of rare inherited heart disease

A new study led by Centenary’s Professor Chris Semsarian AM and Samantha Barrett-Ross from our Molecular Cardiology Program reveals the critical need for greater understanding into diagnosis of little known inherited heart disease.

In collaboration with Wiser Healthcare, Royal Prince Alfred Hospital and the University of Sydney, the study published today in the highest ranking international cardiovascular journal – European Heart Journal, has shown that the use of advanced imaging equipment is driving a significant increase in the diagnosis of a little known inherited heart disease in adults.

In a comprehensive systematic review of 55 studies of Left Ventricular Non-Compaction (LVNC), a rare form of heart disease, the authors of the study have found that an older heart test, echocardiography (which uses ultrasound) diagnosed the condition in 1% of hospital patients and healthy adults. But using a new cardiac MRI test, 15% of adults were reported to have the condition. In some studies, it was much higher, up to 40%, even in studies of large samples of well people.

Professor Semsarian, Head of Centenary’s Molecular Cardiology Program and a leading cardiologist at Royal Prince Alfred Hospital, says, “Finding evidence of heart disease in up to 40% of well adults raises significant questions. Many of the studies were done on well people with no symptoms or signs of heart disease, yet the cardiac MRI showed these abnormal results at alarming levels. This raises questions about the clinical utility of this particular diagnosis. It raises wider concerns too. For example, how should results from new, very sensitive tests be interpreted?”. The study highlights the impact of new technology on what appears to be massive over-diagnosis of the disease. It also provides new insights and guidance on more consistent and accurate diagnosis of LVNC in adults, to enable a reduction in the number of healthy people undergoing the stress of misdiagnosis, and cost and trauma of unnecessary treatment.


Radio Interview

Listen to the ABC RN Health Report interview with Centenary’s Professor Chris Semsarian AM and Samantha Barrett-Ross from our Molecular Cardiology Program.


Read the full media release.

See the published article in the European Heart Journal.