Although the term “heart failure” is a bit of a misnomer, there’s no doubt about its dire consequences. There are over 5 million people in the United States whose hearts simply fail to pump sufficient blood with enough force to fully support their bodies. People with heart failure don’t just feel lethargic and out of breath; they are liable to develop kidney and liver disease, damaged heart valves and stroke.
Because heart failure is associated with aging, it is soon to become an even bigger problem. The American Heart Association estimates that by 2030 the number of patients with heart failure will rise by 50 percent.
In a portion of patients, faulty electrical conduction that prevents the synchronous contraction of the heart’s chambers either causes or contributes to heart failure. A decade ago, physicians began using cardiac resynchronization therapy, or CRT – an implantable device, such as a pacemaker, that coordinates the contraction of both ventricles. Working closely with University of Virginia colleague Dr. Kenneth Bilchick, Biomedical Engineering Professor Frederick Epstein is developing a method to more accurately identify people who could benefit from CRT.
“CRT can make a dramatic difference, improving quality of life and even extending it for many patients,” Epstein said. “The problem is that 40 percent of people currently receiving CRT are not helped.”
In other words, physicians using an electrocardiogram to determine if patients have correctable cardiac dissynchrony are wrong four times out of 10, unnecessarily subjecting people to a procedure that is invasive as well as expensive.
As medical imaging continues to improve – providing sharper and clearer pictures of living human tissues – University of Virginia biomedical engineering professor Frederick Epstein is moving beyond better pictures toward images that quantify the details of the workings of organs such as the heart. This can allow physicians to make more accurate diagnoses and develop more effective treatment plans.
“I’m working on an imaging technology that details to the millimeter the movements of the heart, which can precisely tell a doctor how well or poorly it’s functioning,” said Epstein, new chair of the Department of Biomedical Engineering in the School of Engineering and Applied Science
and School of Medicine.
Epstein, a 1993 Ph.D. graduate of that department, holds a joint appointment with the Medical School’s Department of Radiology. He has dedicated his career to improving the capabilities of noninvasive medical imaging devices, particularly magnetic resonance imaging, which uses magnetic fields to form detailed pictures of the body’s internal structures. Prior to returning to U.Va. as a faculty member in 2000, he worked at General Electric Medical Systems and the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
Epstein currently is working with Siemens, the global electronics company, on developing his new technology, Cine DENSE, or Displacement Encoding with Stimulated Echoes.