Currently, the Centre is leading numerous research studies surrounding its 3 core research priorities; Sudden Cardiac Death / Device Therapy, Early Cardiomyopathy Detection, and Cost Effectiveness / Population Research. While many sub-studies exist within each primary study, a list of the main studies or programs running at the Stephenson Centre is leading are provided below.
CanCARD-MR (Canadian CArdiomyopathy Risk model Development using Magnetic Resonance)
This multi-centre registry is supported by the IMAGE-HF team grant, funded by CIHR (PI: Dr. Rob Beanlands). As Co-Project Principal Investigators Dr. James White (Stephenson Centre) and Dr. David Birnie (Ottawa Heart Institute) are recruiting 500 consecutive patients referred for Implantable Cardiac Defibrillators (ICD) and performing a Cardiac MRI scan. The MRI is being performed to measure the amount of scar tissue in the heart and use this information, along with other patient information, to develop a risk prediction tool that can identify those patients most likely to be saved by their ICD. Currently the study has recruited to 90% of its target thanks to the efforts of multiple Centres across Canada.
MAPIT-CRT
This multi-centre Randomized Controlled Trial (RCT) is funded by the Heart and Stroke Foundation and is run by Dr. White (Stephenson Centre). The study is aimed at testing the ability of 3-dimensional models of the heart - generated from an MRI scan - to guide the delivery of pacemaker leads to locations on the heart that will improve heart function. The study will randomize patients receiving Cardiac Resynchronization Therapy (CRT) to either model-guided or standard CRT lead delivery and follow patients to test for response. There are currently 5 Centres across Canada enrolling in this study.
REFINE ICD
In collaboration with Dr. Derek Exner (Libin Cardiovascular Institute) Dr. Andrew Howarth (Stephenson Centre) is performing a sub-study in the REFINE-ICD clinical trial, aimed at testing the role of ICDs in patients with prior heart attacks and modest reductions in heart function. With already 150 patients enrolled they hope to identify if the amount of scar tissue in the heart can identify patients at higher versus lower likelihood of benefit from these devices. Enrollment is ongoing.
CIROC (Cardiovascular Imaging Registry of Calgary)
At the core of the Stephenson Centre's Researc architecture, CIROC is an ambitious project aimed at enrolling 10,000 patients over 5 years to study the role of a variety of MRI techniques to predict serious cardiac events. Patients with multiple types of heart disease are being studied with several key areas of interest, inclusive of tissue "mapping" techniques, 4D strain analysis and scar analysis. The Centre is currently enrolling at a rate of over 2800 patients per year and is therefore anticpated to reach target enrollment within 4 years. This project is closely partnered with Alberta Health Services through their Analytics department and aims to generate a comprehensive map of both clinical and administrative data relating the performance of cardiac MRI to clinical outcomes and resource consumption. The latter will provide the foundation for our third research priority aimed at evaluating the cost-effectiveness of cardiovascular imaging at a population level.
FABRY Disease Screening Study
In partnership with Dr. Aneal Khan (Alberta Children's Hospital) we are screening patients with Hypertrophic Cardiomyopathy (HCM), a condition characterized by abnormal thickening of the heart muscle, to identify patients with a metabolic condition called Fabry disease. This rare condition is important as it can be treated through an enzyme therapy, hopefully reducing serious heart related complications. All patients at the Stephenson Centre referred for the assessment of HCM are being approached with the aim to recruit approximately 200 patients.
4D Strain Research Group
Led by Dr. Nowell Fine and our post-doctoral fellow, Dr. Alessandro Satriano, the Stephenson Centre has dedicated resources to the study of novel 4-dimensional approaches to the calculation of cardiac "strain", a measure of how the cardiac chambers or vessels deform throughout the cardiac cycle. Software developed by Dr Satriano, called GIESEPPE, allows for the generation of 4-D strain maps of any cardiac stucture (ie: LV, RV, LA) from any dynamic, multi-planar imaging modality (MRI, gated CTA, 3D echocardiography). This sofware is now being tested in a wide range of cardiac diseases. Dr Carmen Lydell (Stephenson Centre) is now also using this software to study patients undergoing TAVI procedures from gated CTA - evlauting both aortic and ventricular strain profiles.
Tissue Mapping Research Group
Led by Dr. Bobby Heydari (Stephenson Centre), the Stephenson Centre is conducting research in both native (pre-contrast) and post-contrast T1 mapping. This rapidly expanding field of research holds promise for the identification of heart disease conventionally challenging to see with routine imaging approaches. Dr. Heydari brings his experience and collaboration from Brigham and Womens Hospital and is assessing novel pulse sequences with validation against established techniques. A variety of patient populations are being examined.
