06.03.2019 change 06.03.2019

Researcher creates a map of the human heart

Photo: Fotolia Photo: Fotolia

Half of us have a mysterious pouch in our hearts that can cause a stroke. How and why does it form? How to detect it? This phenomenon was described by the HEART team and Dr. Mateusz Hołda from the Jagiellonian University Medical College.

The researcher from Kraków was included in the Forbes magazine list of 30 young European leaders in their fields. He explains that scientists still have many unanswered question when it comes to the construction of the heart. The Polish team has already answered one of those questions. Now, researchers are creating a "map of the heart" and want to find a way to image an invisible, but extremely important structure constituting the "nervous system" of the myocardium.

"It would seem that anatomy and morphology are outdated branches of biology that should be closed somewhere deep in university basements, because over several hundred years of development of morphological sciences, everything has been discovered. But my team questions it" - says Dr. Hołda, head of the research team HEART (Heart Embryology and Anatomy Research Team).

PROBLEMATIC POUCH

In 2009, scientists from California discovered a new structure in the heart wall that separates the left atrium from the right. It is called the "septal pouch". Until now it was not known how it forms, whether it has a function, or it should it be considered a pathological entity. The Polish researchers have answered these questions. It turns out that the pouch on the right side of the wall occurs only in 10 percent cases, but very often on the left side - 50 percent people have it. Further study showed that the blood accumulating in the pouch can clot, and the thrombus, when released from the pouch, can cause ischaemic stroke.

"This naturally occurring structure is present in every other person and not everyone who has it will get a stroke" - says Dr. Hołda. He explains that the pouch appears, because in a child in the womb, blood flows freely between the atria through an oval opening. A child in its foetal life does not breathe and blood bypasses the pulmonary circulation. After birth, this natural communication closes. However, an incomplete closure of the oval hole channel creates a pouch. It is filled with blood that has limited mobility and thus can clot.

"Under unfavourable conditions, the thrombus may detach and clog up our arteries, which is why we have developed imaging methods - we determined when it is best visible and how to measure it. The existence of this pouch can be seen in both computed tomography and transesophageal echocardiography" - the researcher says.

Dr. Hołda emphasises that medicine is entering a higher level and physicians perform increasingly complex, less invasive procedures. Knowledge of anatomy is critical for their success. Any variation in the structure of the organ may lead to disorders or hinder or facilitate the movement of the clinician within the heart.

THREE-DIMENSIONAL HEART MODELS

The HEART team explores the details of the architecture of the myocardium and discovers various variants of its structure. Researchers use anatomical preparations and clinical imaging studies. These data, such as computed tomography results, can be visualized and printed in 3D.

"We can make a model of the heart of a particular patient with exceptional accuracy. For several months, printed hearts have been helping cardiac surgeons who treat children understand the individual heart defects very well and select appropriate treatments" - says Dr. Hołda.

He emphasizes that it is not easy for doctors to evaluate hearts that have birth defects. The heart is a very complicated organ. In the case of congenital defects in children, connections between particular heart cavities and its vessels are not obvious and it is very difficult to follow their course.

Heart models are also powerful research tools. They allow to accurately measure the volume of heart cavities. In the past it was unachievable with ordinary two-dimensional scans.

Dr. Hołda`s team joins forces with specialists in many fields at the interface between basic science and clinical science: medical physicists, computer scientists, programmers, biologists, as well as physicians: cardiologists, surgeons, and radiologists. Cooperation with the University of Manchester (United Kingdom) and Minneapolis (US) results in joint research projects and publications in the best cardiology journals.

HEART FOR SCIENCE

In the future, the scientist would like to image the stimulus-conducting system that constitutes the nervous system of the heart. This system stimulates the heart to contract and regulates contractions. It makes the heart contract in a synchronous way. The problem is that you can not see it, and although it is very important, it can not be dissected from muscle tissue. The science that deals with this system is electrophysiology.

Dr Hołda emphasizes that there wouldn`t be any valuable research results if it were not for human nobleness. Kraków has the world`s largest collection of hearts - anatomical preparations for scientific research.

"We study the hearts collected for deceased donors, we have the world`s largest collection of over 400 such preparations, so that we can examine almost all construction variants of the heart and describe all its structures using the same research material. We are preparing a map of human heart that will be unique on a global scale. This distinguishes us from other countries" - the researcher says.

He argues that donation programs work well in Polish anatomy departments. To donate the body to science after death, willing donors should find the website of the selected Medical University and ask the office of anatomy department employees for guidance; they will explain the procedures. Dr. Hołda assures that it is not a complicated process and many noble people decide to take this step.

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The researcher is an ambassador of the #Jestemartowcem campaign of the Foundation for Polish Science. The campaign aims to collect funds, including 1 percent PIT donations, for funding additional scholarships for the best young scientists. Dr. Hołda is a holder of the START scholarship.

PAP - Science in Poland, Karolina Duszczyk

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