The following is a guest blog post by Gary Boas, Director of Radiology Research Communication at Massachusetts General Hospital.

Boas’ work focuses on highlighting to broad audiences the scientific discoveries that happen behind the doors of the imaging/radiology department. In his free time, he likes to spend time building out his Tiki bar.

In 1971, on the opening track of their album Trafalgar, pop group the Bee Gees posed the immortal question: how can you mend a broken heart? The Brothers Gibb, of course, were speaking figuratively. The song falls squarely in the “how can I live after I’ve lost my love” tradition.

Here at Mass General, researchers often also approach the question literally. Following are five recent studies from the Department of Radiology in which researchers find innovative techniques to help reduce the incidence of a broken heart (A.K.A keep a healthy heart).

Cardiovascular diseases, including heart attack and stroke, are the leading cause of death around the world. Tools are available for the prevention of cardiovascular disease but are not as widely applied as they might be—in part because of the relative lack of means to identify those at the highest risk of disease, who would benefit most from use of the tools. 

 Now, researchers Michael T. Lu, MD, MPH and Vineet Raghu, PhD, both of Mass General’s Cardiovascular Imaging Research Center (CIRC), and Jakob Weiss, MD, a senior resident in Radiology, have reported an AI tool that predicts the 10-year risk of heart attack and stroke based on existing chest X-ray images. Chest X-rays are among the most common tests in medicine, especially in older adults. 

 Drs. Lu and Raghu elaborate: “Many people have existing chest radiographs but not the inputs to the Pooled Cohort Equation risk calculator,” the currently recommended tool to determine eligibility for statin medications. “Opportunistic screening of chest radiographs could identify additional patients who may benefit from statins and ultimately prevent heart attack and stroke.” 

In a recent paper, the Martinos Center’s David Izquierdo-Garcia, PhD and colleagues described a new, noninvasive means of identifying thrombosis in the body. The title of the paper— “Detection and Characterization of Thrombosis in Humans Using Fibrin-Targeted Positron Emission Tomography and Magnetic Resonance”—is a bit weighty. So Dr. Izquierdo-Garcia, lead author of the study, breaks it down in this video. 

David Sosnovik, MD and colleagues have produced intriguing results using a nanoparticle they developed for use with fluorescence or magnetic resonance imaging. Dr. Sosnovik is director of the Program in Cardiovascular Imaging at the MGH Martinos Center for Biomedical Imaging. 

The nanoparticle allows researchers to measure changes in autophagy, a process by which cells remove unnecessary or dysfunctional components. Reduced levels of autophagy have been linked to cardiovascular disease and other conditions. In a study published last year, Dr. Sosnovik and colleagues applied the new tool to measure changes in autophagy in heart tissue under different conditions. 

“We show with our nanoparticle that intermittent fasting—drinking water but no food for 24 hours before the chemotherapy is given—restores autophagy, eliminates the damage to the heart muscle, and even improves overall survival,” he says. “We are not suggesting that patients today fast before their chemotherapy. This is something that will need to be studied further in controlled and vigorous clinical trials. However, our paper provides important insights that may affect clinical care in the near future.” 

Jagpreet Chhatwal, PhD and colleagues have shown that wrist-worn devices can accurately detect atrial fibrillation (AF) and may be a more cost-effective alternative for screening and monitoring the condition. AF is the most common form of heart arrhythmia and, when undiagnosed, a leading cause of stroke. 

 “The proliferation of wrist-worn devices for AF detection provides a convenient option for population-wide screening, though it’s not known if their use will lead to increased costs and problems related to follow-up testing and false positives,” says Dr. Chhatwal, director of the MGH Institute for Technology Assessment (ITA) in the Department of Radiology. 

 “We therefore simulated a virtual trial comparing clinical and cost outcomes under different AF screening strategies and showed that those using wrist-worn devices generally resulted in greater benefits compared to traditional modalities, and at a cost deemed affordable to the healthcare system.” 

Recent research into the roles of different white blood cell types in arrhythmia could have important implications for the development of new treatments. In a study reported last year, Matthias Nahrendorf, MD, PhD, a researcher in MGH’s Center for Systems Biology, and colleagues revealed the opposite effects of neutrophils and macrophages on a type of recurring irregular heartbeat called ventricular tachycardia (VT): namely, neutrophils can engender VT while macrophages protect against it. 

“Inflammatory neutrophils give rise to arrhythmia by compromising the electrical function of heart muscle cells called cardiomyocytes,” Nahrendorf says. “Macrophages, which take up debris, are protective, and deleting them gave rise to electrical storm in mice who experienced a heart attack. Indeed, these mice were more likely to die from arrhythmia.” 

The findings point to the possibility of new targeted therapies for irregular heartbeat that could help reduce the risk of sudden cardiac death.