THE world’s first atlas of the human heart can take you inside the organ just like Google Earth, scientists say.
Astonishing technology allows viewers to look at one healthy and one diseased heart in “unprecedented detail”.
Experts hope the technology will be “invaluable” in helping them better understand cardiovascular disease and “accelerate” medicine in the field.
Professor Peter Lee, senior author of the study from University College London (UCL) Mechanical Engineering, said: “The atlas that we’ve created in this study is like having Google Earth for the human heart.
“It allows us to view the whole organ at global scale, then zoom in to street level to look at cardiovascular features in unprecedented detail.
“Being able to image whole organs like this reveals details and connections that were previously unknown.”
The study, published in the journal Radiology, provides a map of the human heart that captures the anatomical structure of the whole organ down to 20 micrometres – half the width of a human hair.
In certain areas, imaging has been done to cellular level.
It provides a 3D look inside two whole adult human hearts – one healthy and one diseased.
The team hope it will “facilitate previously impossible research into both healthy and diseased hearts”.
By “clarifying anatomical structures and connections”, they could improve treatment options for arrhythmia – an abnormality of the heart’s rhythm – and create more lifelike models for surgical training, they added.
Prof Lee said: “One of the major advantages of this technique is that it achieves a full 3D view of the organ that’s around 25 times better than a clinical CT scanner.
“In addition, it can zoom in to cellular level in selected areas, which is 250 times better, to achieve the same detail as we would through a microscope but without cutting the sample.”
Professor Andrew Cook, an author of the study and a heart anatomist from the UCL Institute of Cardiovascular Science, added: “With today’s technology, an accurate interpretation of the anatomy underlying conditions such as arrhythmia is very difficult.
“So, there is enormous potential to inspire new treatments using the imaging technique that we’ve demonstrated here.
“We believe that our findings will help researchers understand the onset of cardiac rhythm abnormalities and also the efficacy of ablation strategies to cure them.
“For example, we now have a way to determine differences in the thickness of tissue and fat layers located between the outer surface of the heart and the protective sac surrounding the heart, which could be relevant when treating arrhythmia.”
Cardiovascular disease is the biggest cause of mortality worldwide.
Ischaemic heart disease, a weakening of the heart caused by reduced blood flow, was itself responsible for 8.9million or 16 per cent of deaths globally in 2019 – a figure that had risen by more than two million since 2000.
Clinicians typically use imaging techniques such as ultrasound, CT and MRI to diagnose cardiovascular disease, but these don’t provide detailed structural information about what’s happening in an organ.
To get this, they have to slice organs into thin sections to be scanned, which significantly limits the field of view.
In recent years, a type of particle accelerator called a synchrotron has been used to develop new imaging techniques that overcome these limitations.
Synchrotron studies on whole foetal and small animal hearts have been published, though these have always been at scales much smaller than major adult organs.
This is the only place in the world where complete adult human organs can be imaged with such a high level of contrast
Paul Tafforeau
In this study, scientists from UCL and the European Synchrotron Radiation Facility (ESRF) used an X-ray technique called Hierarchical Phase-Contrast Tomography (HiP-CT) to image two whole adult human hearts down to a scale of 20 micrometres, providing a comprehensive and detailed 3D view of the entire organ.
The detailed imaging of the cardiac conduction system, which generates and transmits the electrical signals that drive the heart muscle’s pumping action, is one example of how the study will impact cardiovascular medicine, the authors said.
While the imaging of the two hearts is an important milestone for cardiovascular medicine, the researchers added that they will need to study more hearts to understand variation between people, taking into account differences in age, sex, ethnicity and disease progression.
The two hearts were imaged at the ESRF, which houses the world’s brightest X-ray source, in Grenoble, France.
One came from a 63-year-old man with no known cardiac disease, and the other was from a woman, 87, with a history of ischaemic heart disease, high blood pressure, and atrial fibrillation.
It wouldn’t be possible to image a living person’s heart in this way as the radiation dose would be too high.
Dr Joseph Brunet, first author of the study from UCL Mechanical Engineering and ESRF visiting scientist, said: “The first time you see the heart with HiP-CT it is quite surprising as it clearly shows soft tissue not typically visible with conventional X-ray imaging.
“This is only possible because of the way that the phase contrast X-rays interact with these tissues, as well as the high energy that the ESRF can generate in order to penetrate the whole organ.”
This resolution is not without its challenges, though.
Imaging for each heart generated 10 terabytes of data – one million times more than a standard CT scan.
Paul Tafforeau, an author of the study from ESRF who invented the HiP-CT technique, said: “The ESRF’s beamline facility is currently the only place in the world where complete adult human organs can be imaged with such a high level of contrast, and we are still quite far from the limits of the technology.
“The main limiting factor is the processing of the very large data produced by HiP-CT.”
A showcase of the heart atlas and the technology behind it will be featured at The Wonders – part of the UCL Festival of Engineering – for free on July 19 at the Bloomsbury Theatre in London.
A heart that’s in tip-top condition is vital for a long and healthy life.
Exercise is one of the best things you can do for the heart because it helps reduce risk factors of heart disease, including obesity, high blood pressure and stress.
The NHS recommends that each week, adults do at least 150 minutes of moderate-intensity activity, such as brisk walking or water aerobics, or 75 minutes of vigorous-intensity exercise, such as running.
But you’ll be glad to hear that working out isn’t the only approved way to ensure your heart is in peak condition.
From joining a book club to snacking on nuts, a heart doctor has given health journalist Lucy Gornall her top tips to keep your ticker in good nick.
Dr Gosia Wamil, a consultant cardiologist at Mayo Clinic Healthcare in London, said:
