Patients with angina and muscle bridging remain underrepresented in clinical research, despite it affecting a large number of patients. We hope that a better understanding of the causes of angina in these patients, as established by our study, will lead to further research that investigates appropriate treatment options in order to improve quality of life in these patients”.Dr Aish Sinha
08 February 2024
Dr Aish Sinha wins Samuel A Levine Early Career Clinical Investigator award
Dr Aish Sinha has won the prestigious Samuel A Levine Early Career Clinical Investigator award for his work uncovering the mechanism linking heart muscle bridges and angina.
The award acknowledges and seeks to incentivize ground-breaking clinical research undertaken by early career investigators and trainees, while also fostering careers in clinical cardiovascular investigation. It was presented to Dr Sinha, a clinical research fellow based within the School of Cardiovascular and Metabolic Medicine & Sciences and Guy’s and St Thomas’ Trust, at the American Heart Association (AHA) annual conference.
The study, titled 'Characterizing Mechanisms of Ischemia in Patients With Myocardial Bridges', has been published in Circulation: Cardiovascular Interventions and was led by Professor Divaka Perera. It aimed to better understand the role that heart muscle bridges play in the development of angina in patients without any large vessel narrowing.
Angina refers to chest pain stemming from an imbalance in the supply and demand of blood to the heart muscle. It was previously thought to occur solely due to narrowing in the large blood vessels supplying the heart muscle. However, cardiologists now know that the blood supply/demand mismatch can occur for a variety of other reasons.
The heart features a network of large blood vessels running along its surface. However, in roughly 20-25% of all people, the large blood vessels dip into the heart muscle for a short segment and then come back out. This is known as a muscle bridge and, in a vast majority of cases, is a simple and benign variant of anatomy. However, in a small group of patients, these muscle bridges represent an abnormality that leads to blood supply/demand mismatch during exercise. However, exactly how this mismatch occurs was unknown.
In this study, Dr Aish Sinha and colleagues set out to uncover the mechanisms that lead to this aberration. Patients enrolled in the study undertook an angiogram, which involves injecting a special dye into the blood vessels and taking x-ray images. The researchers then passed a special ultra-thin wire into the blood vessel to measure pressure and flow at rest. Using a unique set up, patients then undertook bicycle exercise using an ergometer attached to the end of the bed while the researchers measured blood flow and pressure.
Post-processing of this data allowed the researchers to identify the mechanism of blood supply/demand mismatch during exercise in selected patients with muscle bridges. These novel findings may promote the development of new therapies that may improve these patients’ quality of life in the future.