A young Asian boy holding a red heart in both hands to symbolize heart shape and links with congenital heart defect (CHD)
Credit: krisanapong detraphiphat/Getty Images.

Results from a study using artificial intelligence and magnetic resonance imaging show that heart shape can be an indicator of cardiac problems.

The research, led by Cedars-Sinai Medical Center in Los Angeles and Stanford University and published in the journal Med, showed people with rounder shaped hearts were more likely to develop heart rhythm problems like atrial fibrillation and heart muscle disorders like cardiomyopathy.

Cardiac imaging using technology such as ultrasound and magnetic resonance imaging (MRI) has long been a part of diagnosis and treatment for cardiovascular conditions. But, artificial intelligence (AI) capabilities have improved dramatically in the last few years making highly detailed analysis possible that was not an option before.

“We have established traditional ways of evaluating the heart, which have been important for how we diagnose and treat heart disease,” co-lead author Shoa Clarke, a preventive cardiologist and an instructor at Stanford University School of Medicine, explained in a press statement.

“Now with the ability to use deep-learning techniques to look at medical images at scale, we have the opportunity to identify new ways of evaluating the heart that maybe we haven’t considered much in the past.”

To test whether heart shape was an indicator of cardiac health, Clarke and colleagues used AI to analyze MRI images of the heart from 38,897 individuals enrolled in the UK Biobank. People who had abnormal left ventricular size or systolic function were not included in the analysis.

The researchers found that each standard deviation increase in heart roundness was linked with a 47% increased in the risk of cardiomyopathy and a 20% increase in risk of atrial fibrillation, after correcting for confounders.

As genetic information and sequence is available for most participants of the UK Biobank, the researchers then looked to see if there were any genetic variants that could be behind differences in heart shape. They found four areas in the genome with variants that appeared to be significantly associated with heart roundness.

“By looking at the genetics of sphericity, we found four genes associated with cardiomyopathy: PLN, ANGPT1, PDZRN3, and HLA DR/DQ,” said co-lead author David Ouyang, a cardiologist in the Smidt Heart Institute at Cedars-Sinai. “The first three of these genes were also associated with a greater risk of developing atrial fibrillation.”

The researchers say that more studies are needed to confirm their results and investigate the impact of heart shape on cardiovascular disease risk in more detail, but hope their results can provide useful information for cardiologists on possible heart disease risks for patients in the future.

“A change in the heart’s shape may be a first sign of disease,” said Christine Albert, chair of the Department of Cardiology in the Smidt Heart Institute and a study author. “Understanding how a heart changes when faced with illness—coupled with now having more reliable and intuitive imaging to support this knowledge—is a critical step in prevention for two life-altering diseases.”

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