Advanced Imaging Techniques in the Detection of Rheumatic Heart Disease

2016 Health Professional Scholarship

Years funded: 2017-2020

Rheumatic heart disease (RHD), a consequence of acute rheumatic fever (ARF), is a disease of poverty. It remains one of the most important causes of cardiovascular morbidity and mortality among socially and economically disadvantaged populations, despite the dramatic drop in prevalence within developed nations. There is also evidence of disproportionate incidence in underprivileged populations within the same country. Despite a dramatic reduction of RHD in Australia overall, it continues to be a major contributor to childhood and adult cardiac disease in Indigenous communities.

There are significant limitations in existing diagnostic tools used in the management of ARF and RHD. Broadening of the diagnostic criteria for ARF will result in over-diagnosis and unnecessary medical intervention, including the administration of prophylactic long- acting intramuscular penicillin every 3-4 weeks for a minimum of 10 years, which represents a major hardship in this patient population. Conversely, more restrictive criteria may lead to significant under-diagnosis, causing increased development of RHD-related valvular heart disease leading to morbidity and premature death.

The proposed research will demonstrate changes in heart muscle and valve structure and function using non-invasive testing. We seek to enhance the detection of patients with suspected ARF and improve the prediction of the development of future RHD in at-risk individuals.