Advanced Cardiometabolic Imaging

Background

Cardiovascular magnetic resonance (CMR) imaging provides non-invasive assessment of cardiac structure, function, tissue characteristic and perfusion in one single examination, with superior diagnostic accuracy and reproducibility without exposure to radiation. It is now recognized as the ideal imaging modality for clinical trials. Furthermore, it allows assessment of multiple organs in one session for mechanistic study of inter-organ links in pathophysiology.

Our Core Lab has a dedicated team of clinician scientists, researchers, physicists and radiographers that supports CMR-related research studies across NHRIS and multi-centre/multi-disciplinary collaborations.

Expertise

1. CMR study design and image optimization on both 1.5T and 3T platforms.

2. Our Core Lab (ISO 13485 certified) provides comprehensive analysis of cardiac structure (volumes, mass, dimensions and fat deposition), function (myocardial strain), tissue characterization (late gadolinium enhancement, T1/T2/T2*) and myocardial perfusion.

Methodology

Our Core members are experienced and trained analysts. Imaging analysis is done according to standardized protocols. Image interpretation is based on our published reference values (cardiac dimensions, strain and exercise capacity) for local population.

Research Area

1. Image-based phenotyping of healthy volunteers and inherited cardiomyopathies – NHRIS Biobank
   

2. Biomarkers of cardiac fibrosis – REMODEL Study (NCT02670031)
   

3. Exercise stress CMR – EMPIRE Trial (NCT03217227)
   

4. CMR-related clinical trials – ATTRaCT (NCT0279100), CRESCENT (NCT04119999), PITRI (NCT03102723)
   

5. Cardiometabolic imaging
   

6. Ocular imaging and cardiac biomarkers for microvascular disease
   

Achievements

Awards

1. Exercise-induced stress CMR for detection of coronary artery disease (EMPIRE) – NMRC Open Fund Young Investigator Research Grant (2017-2022)
   

2. Validating Biomarkers of Myocardial Fibrosis and Investigating Therapies to Regress Fibrosis – NMRC Clinician Scientist Award (2018-2022)
   

3. Role of ARNi in ventricular remodeling in hypertensive LVH (REVERSE-LVH) – NMRC Clinical Trials Grant (2018 – 2023)
   

4. Quantification of Retinal and Choroidal Microvascular Parameters Using Wide-field Optical Coherence Tomographic Angiography in Patients with Systemic Hypertension – Duke-NUS Khoo Collab (2018 – 2021)
   

5. Validating Echocardiographic Global Longitudinal Strain as a Marker of Myocardial Fibrosis in Hypertensive Heart Disease (2nd year) – Duke-NUS Charles Toh Cardiovascular Fellowship Fund (2020-2021)
   

6. Association of Fatty Liver Disease and Diabetes Cardiomyopathy – Duke-NUS New Toyo Cardiovascular Research and Education Fund (2021)
   

7. Identifying Asians at risk of cardiovascular complications who have recently recovered from COVID-19 – NHG-NCID COVID 19 Center Grant (2021-2022)
   

8. Exercise-induced Stress Cardiovascular Magnetic Resonance for Evaluation of Chest Pain (EXCEL) – NMRC Individual Research Grant (2022-2025)
   

Selected Publications

1. Le TT, Tan RS, De Deyn M, Goh EP, Han Y, Leong BR, Cook SA, Chin CW. Cardiovascular magnetic resonance reference ranges for the heart and aorta in Chinese at 3T. J Cardiovasc Magn Reson. 2016 Apr 12;18:21.
   

2. Chin CW, Everett R, Kwiecinski J, Vesey A, Yeung E, Esson G, Jenkins W, Koo M, Mirsadraee S, White A, Japp A, Prasad S, Semple S, Newby D, Dweck. Myocardial Fibrosis and Cardiac Decompensation in Aortic Stenosis. JACC Cardiovasc imaging 2017; 10(11):1320-1333
   

3. Le TT, Bryant JA, Ting AE, Ho PY, Su B, Teo RC, Gan JS, Chung YC, O'Regan DP, Cook SA, Chin CW. Assessing exercise cardiac reserve using real-time cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2017 Jan 23;19(1):7.
   

4. Anand A, Chin CW, Shah ASV, KwieciÅ Ski J, Vesey A, Cowell J, Weber E, Kaier T, Newby DE, Dweck M, Marber MS, Mills NL. Cardiac myosin-binding protein C is a novel marker of myocardial injury and fibrosis in aortic stenosis. Heart 2017; 104(NA):1101-1108
   

5. Walsh R, Buchan R, Wilk A, John S, Felkin LE, Thomson KL, Chiaw TH, Chin CW, Pua CJ, Raphael C, Prasad S, Barton PJ, Funke B, Watkins H, Ware JS, Cook SA. Defining the genetic architecture of hypertrophic cardiomyopathy: re-evaluating the role of non-sarcomeric genes. Euro Heart J 2017; 38(46):3461-3468.
   

6. Goh VJ, Le TT, Bryant JA, Wong JI, Su B, Lee CH, Pua CJ, Sim CPY, Ang B, Aw TC, Cook SA, Chin CW. Novel index of maladaptive myocardial remodeling in hypertension. Circ Cardiovasc Imaging 2017 Sep;10(9).
   

7. Cai J, Bryant JA, Le TT, Su B, de Marvao, A, O’Regan DP, Cook SA, Chin CW. Fractal analysis of left ventricular trabeculations is associated with impaired myocardial deformation in healthy Chinese. J Cardiovasc Magn Reson. 2017 Dec 14;19(1):102.
   

8. Bulluck H, Bryant JA, Tan JZ, Go YY, Le TT, Tan RS, Lim TK, Tang HC, Lath N, Low AS, Chin CW, Cook SA, Hausenloy DJ.　Gender differences in native myocardial T1 in a healthy Chinese volunteer cohort. Cardiovasc Imaging Asia 2017; 1(110).
   

9. Chin CW, Kwiencinski J, Everett RJ, White AC, Semple S, Yeung E, Jenkins WJ, Shah AS, Koo M, Mirsadraee S, Lang CC, Mills N, Prasad SK, Jansen MA, Japp AG, Newby DE, Dweck MR. Adverse prognosis associated with asymmetric myocardial thickening in aortic stenosis. Eur Heart J Cardiovasc Imaging 2018; 19(3):347-356.
   

10. Everett RJ, Tastet L, Clavel MA, Chin CWL, Capoulade R, Vassiliou VS, Kwiencinski J, Gomez M, van Beek EJR, White AC, Prasad SK, Larose E, Tuck C, Semple S, Newby DE, Pibarot P, Dweck MR.　Progression of hypertrophy and myocardial fibrosis in aortic stenosis: a multicenter cardiac magnetic resonance study. Circ Cardiovasc Imaging. 2018; 11:e007451.
    

11. Aw TC, Huang WT, Le TT, Pua CJ, Ang B, Phua SK, Yeo KK, Cook SA, Chin CW. High-sensitivity cardiac troponin in cardio-healthy subjects: a cardiovascular magnetic resonance imaging study. Sci Rep 2018;8(1):15409.
    

12. Chua J, Chin CW, Hong J, Chee ML, Le TT, Ting DSW, Wong TY, Schmetterer L. Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography. J Hypertens 2019;37(3): 572-580.
    

13. Chua J, Chin CW, Tan B, Wong SH, Devarajan K, Le TT, Ang M, Wong TY, Schmetterer L. Impact of systemic vascular risk factors on the choriocapillaris using optical coherence tomography angiography in patients with systemic hypertension. Sci Rep 2019;9(1):5819.
    

14. Le TT, Bryant JA, Ang BWY, Pua CJ, Su B, Ho PY, Lim S, Huang W, Lee PT, Tang HC, Chin CT, Tan BY, Cook SA, Chin CW. The application of exercise stress cardiovascular magnetic resonance in patients with suspected dilated cardiomyopathy. J Cardiovasc Magn Reson 2020; 22(1):10.
    

15. Phua AIH, Le TT, Tara SW, De Marvao A, Duan J, Toh DF, Ang B, Bryant JA, O'Regan DP, Cook SA, Chin CW.　Paradoxical higher myocardial wall stress and increased cardiac remodeling despite lower mass in females.　J Am Heart Assoc.　2020 Feb 18;9(4):e014781.
    

16. Le TT, Lim V, Ibrahim R, Teo MT, Bryant J, Ang B, Su B, Aw TC, Lee CH, Bax J, Cook S, Chin CWL.　　The remodelling index risk stratifies patients with hypertensive left ventricular hypertrophy. Eur Heart J Cardiovasc Imaging. 2021; 22(6):670-679
    

17. Le TT, Ang BWY, Bryant JA, Chin CY, Yeo KK, Wong PEH, Ho KW, Tan JWC, Lee PT, Chin CWL, Cook SA. Multiparametric exercise stress cardiovascular magnetic resonance in the diagnosis of coronary artery disease: the EMPIRE trial.　J Cardiovasc Magn Reson.　2021 Mar 4;23(1):17.
    

18. Chua J, Le TT, Tan B, Ke M, Li C, Wong DWK, Tan ACS, Lamoureux E, Wong TY, Chin CWL, Schmetterer L.　Choriocapillaris microvasculature dysfunction in systemic hypertension.　Sci Rep.　2021 Feb 25;11(1):4603.