Our Speaker Dr. James White

Posted by David Holden
 
Dr. James White has been appointed as the Director of the Stephenson Cardiovascular MR Centre. The Centre has achieved a reputation of excellence over the past five years and is a world class program for the delivery of clinical care, research, and education.
 
Dr. Sonny Belenkie introduced Dr. James White as our speaker.
 
  • Arrived in Calgary 3.5 years ago when he was named Director
  • Centre is 12 years old.  Founded on philanthropy.  A success story for Calgary and Calgary now has some of the best resources in the world related to cardiovascular disease
  • Highlight where the research is taking them, for imaging from 2D (picture) to 3D (with 360o view), to 4D (including heart motion during full cycle), to 5D (including mapping the blood’s fluid flow characteristics – laminar flow versus spiralling flow with differences in valve geometry)
  • Why these new techniques?
  • Example of a power drink caused a 20 year old to have ventricle fibrillation
  • 2D image did not show anything abnormal
  • MRI scan showed (from 360o view in very high resolution) showed a white area at the bottom of his heart
  • That white area turned out to be an injury to the heart muscle
  • That lead to a series of other questions that lead the determination of the power drink as the cause (which is available at every corner store) main artery (coronary artery) went into spasm which blocked the flow of blood long enough to cause him to go into cardiac arrest
  • He was part of a study about the role of MRI to find out the causes of sudden cardiac death
  • Major problem … 1 in 5 in this room will die suddenly due to a cardiac arrhythmia
  • Why does it happen, tissue of the heart is either transiently upset because of loss of blood supply or prior damage that leads the electricity to get disorganized in the heart muscle
  • This study took 81 survivors of ventricular arrhythmias and showed that MRI could distinguish between the various causes and they found 50% of the patients had new diagnosis that they were unable to find with previous testing
  • How does MRI do this?  MRI can highlight the areas that can cause future issues by controlling the “magnets” (protons) inside one’s body … vibrate to the point of being able to get them to send a signal back without any radiation whatsoever
  • That is why having an MRI is noisy (the vibrating protons)
  • What does this mean?
  • The found area of scare tissue is very meaningful in determining the likelihood of a future sudden cardiac death
  • They now have therapies available, called an implantable cardiac defibrillator (an onboard paramedic) that will protect those at higher risk
  • Can also use the 3D pictures to guide catheters inside the heart to get rid of the abnormal electrical currents inside the heart
  • This is now personalized care, specific to individuals and their circumstances and risks
  • All of the above is based on 3D imaging, how do we go to 4D?
  • 4D adds time to allow the image to show the full cardiac cycle
  • That information is very valuable as it gives further insight into individual hearts that may be moving in different way
  • They use this information to teach computers the various patterns
  • Using head on view of the hear, called a bullseye model, patterns emerge
  • Computers can distinguish the various unique patterns (another example of technology possibly displacing humans at work … (Editor’s Note:  who among us is safe from this?)
  • Dr. White committed (with tongue firmly in cheek) to release all of this on the day of his retirement as he is working himself out of a job
  • Can they push it one step further … working on now is 5D which introduces the blood flow modelling into the model by tracking individual blood particles inside the hear during the cardiac cycle
  • Flow patterns can provide more information in diagnosis
  • For example, the previously mentioned tornado-like flow due to the existence of a bicuspid valve instead of a tricuspid valve.  This can lead extra stress on the aorta which could lead to aortic rupture
  • This is creating mountains of data about cardiovascular disease which ultimately will be a resource for computers and AI in diagnosis.
Dr. White answered many audience questions on a variety of related subjects.
 
Al McMillan thanked our speaker.
 
Dr. James White