Associate Professor Andre La Gerche

Early detection of heart injury with novel exercise imaging

Associate Professor Andre La Gerche, Baker Heart and Diabetes Institute

2018 Future Leader Fellowship

Years funded: 2019-2022

Patients do not present complaining of ‘heart failure’. Rather, they present with symptoms of exercise intolerance, fatigue or breathlessness. A patient-centric approach to diagnostics involving a comprehensive assessment of the entire oxygen utilisation pathway is needed to address patients' symptoms.

The central hypothesis underlying this research plan is that the quantification of cardiac reserve facilitates a more sensitive, accurate and comprehensive diagnosis than current standard of care.

The primary objective over the next 4 years is to use these novel exercise imaging tools to:

• Identify subtle chemotherapy-induced myocardial injury to predict those at risk of functional disability.
• Determine whether right ventricular contractile reserve in patients with pulmonary hypertension is associated with better outcomes.
• Quantify atrial contractile reserve as a potential marker of atrial fibrillation risk.
• Assess interactions between exercise and genetic risks for atrial fibrillation.

This research agenda addresses conditions associated with significant health burden. Cardiovascular disease is the most significant cause of morbidity and death in cancer survivors and the projects detail potential for early and accurate detection of those most at risk whilst simultaneously investigating exercise as a preventative therapy. The latter projects address atrial fibrillation, a condition associated with greater morbidity and health costs over the last 15 years than all other cardiac conditions. An extremely novel athletic model has the potential to inform genetic discoveries and enhance current preventative therapies by enabling them to be accurately targeted to the population most at risk.