Grant: Project Grant

Heart failure (HF) affects over half a million Canadians and growing. Acute HF is a leading cause of hospitalization (>65 years) and 20-30% of these patients die with 6 months, with a cost of billions of dollars a year. Cardiogenic pulmonary edema (water in the lungs) is a key symptom of HF (a result of poor heart function) and is a major cause of shortness of breath. Treating edema is the primary treatment in acute HF. However, pulmonary edema is most commonly assessed with qualitative tests like a stethoscope and/or chest X-ray. There is a widely recognized need for safe tests that can quantify the amount of water in the lungs in patients with pulmonary edema, particularly for the evaluation of existing and newly developed treatments. We propose that magnetic resonance imaging (MRI) is an ideal teat for assessment of pulmonary edema (the source of MRI signal is water). We will develop new fast MRI methods to make lung water maps. The aims of our proposed research program are to first to develop new MRI methods that will allow fast and accurate images of the amount of water in the lungs. We will use these methods determine normal values for MRI lung water density. These values are need in order to identify which patients have elevated lung water. Second, we will study heart failure patients admitted to hospital for acute HF, who are treated primarily for their pulmonary edema. We will measure the change in lung water with standard hospital therapy (e.g. diuretic). We will show that we can directly measure the amount of water removed with therapy, and thus show that MRI is a good test to study new drugs. Finally, we will determine the relationship between elevated lung water and subsequent events, such as emergency room visits, hospitalization or death. We will show that elevated lung water will predict these events. This is important as we will be able to identify which patients need to managed more aggressively, to help avoid these future events.