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New technique unlocks the secrets of the heart's success

Thursday 13 April

Pioneering research by scientists and physicians at Imperial College and the Royal Brompton Hospital, London, has revealed the elegance of the sinuous shape of the heart. Asymmetrically swirling flow patterns and direction changes in heart cavities may be important for smooth, efficient heart action, enabling it to move blood through the body efficiently, especially with the increased demands of exercise.

The work which is published in the journal Nature today (1) gives new insights into relationships between the heart's overall shape and the dynamics of flow through it.

The authors suggest that their findings and interpretations may have fundamental biological importance. Lead author Dr Philip Kilner said, "This could be one of the keys to the success of vertebrates. It is a factor that may have helped species, like ourselves, with backbones and a looped heart to become relatively large, active and versatile. Vertebrates generally grow larger, swim further, run faster - even occasionally think better - than invertebrates."

To arrive at their novel view of the heart's action, the team scanned the hearts of 22 healthy adult men using a new non-invasive technique known as magnetic resonance velocity mapping (2). The flow maps were processed to appear as streamline images which show directions and structures of flow.

Dr Kilner said: "This has been collaborative work, using methods developed by our physics team, with advanced image processing for clear visualisation of flow"

The resultant maps of flow revealed that blood movement through the heart is not simply a cycle of filling and ejection, in and out of the atria and ventricles (3). Rather, the streaming blood is helped on its way courtesy of the heart's asymmetries and curvatures.

It is suggested that the action of the heart in propelling blood to the lungs and the rest of the body is improved by a dynamic enhancement, whereby blood is redirected and slung through the sinuous curvatures with a minimal loss of energy in a fluent, sling-like 'morphodynamic' action.

The findings may have relevance for the management of heart disease, even if they may not be of critical importance - the fluid dynamics advantages described apply during exercise rather than at rest or normal activity.

Nevertheless, appreciation the healthy interactions of form and flow may be important for optimisation of heart operations, or of interventions such as electrical pacing or drug treatment, especially in patients who wish to remain physically active.

A special web site has been created by the authors to give journalists and members of the public access to supplementary material and background to the research (4).

Web site at:


For further information please contact:

Dr Philip Kilner Cardiovascular Magnetic Resonance Unit
Royal Brompton and Harefield NHS Trust
London SW3 6NP
Tel: 020 7351 8808
Fax: 020 7351 8816

Tom Miller
Imperial College Press Office
Tel: 020 7594 6702
Fax: 020 7594 6700

Notes to Editors:

1. The research is published in the article "Direction-changes and asymmetries of flow through the heart" in the journal Nature on 13 April 2000 (Vol 404, pp759-761).

Authors: Philip J Kilner*, Guang-Zhong Yang*?, A John Wilkes ?, Raad H Mohiaddin*, David N Firmin*, Magdi H Yacoub §. *Cardiovascular diovascular Magnetic Resonance Unit, ? Visual Information Processing Group of Department of Computing and § Department of Cardiothoracic Surgery, Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology,Sydney Street, London SW3 6NP, UK. ? Flow Design Research Group, Emerson College, Forest Row, East Sussex RH18 5JX, UK

2. This technique allows blood flow through the living heart to be quantified and visualised. The technique uses movements of hydrogen atoms in water molecules, so no contrast agent or marker is needed for this non-invasive flow imaging technique.

3. Structure and function of the human heart. The human heart consists of four compartments, known as chambers: the left and right atria (singular atrium) form the top portion of the heart, and the left and right ventricles from the bottom half of the heart. The atria are the upper chambers and receive blood that is being returned to the heart. The right atrium receives blood that has circulated throughout the body delivering oxygen and nutrients, and the left atrium fills with newly oxygenated blood returning from the lungs when the atria are relaxed. When the atria contract, they push the blood through valves into the relaxed ventricles. When the ventricles contract, the right ventricle pumps blood to the lungs and the left ventricle pumps blood to the body. This continuous cycle of synchronised contractions is driven by the heart's electrical system.

4. A web site entitled 'The Fluent Heart', has been created by the article's coauthors Drs Philip Kilner and Guang-Zhong Yang, to give journalists and members of the public access to material supplementary to the paper published in Nature. In addition the site also offers examples of formative movements in fluids, and of cyclic flows in sculpted cavities of Flowforms. These views of fluid in movement may throw light on aspects of blood flow through the heart.
Web address:

4. Imperial College of Science, Technology and Medicine is an independent constituent part of the University of London. Founded in 1907, the College teaches a full range of science, engineering, medical and management disciplines at the highest level. The College is the largest applied science and technology university institution in the UK, with one of the largest annual turnovers (£330 million in 1998-99) and research incomes (£173 million in 1998-99). It is consistently rated in the top three UK university institutions for research quality, with an aggregate score of 6.09 out of 7 in the 1996 Research Assessment Exercise.
Web site at

5. Royal Brompton Hospital, part of the Royal Brompton and Harefield NHS Trust, is one of world's foremost heart and chest hospitals with units specialising in treatment of heart failure, cardiac surgery and transplantation, congenital heart disease, preventive and invasive cardiology, and imaging. It is closely allied to the National Heart and Lung Institute of Imperial College for cardiology post-graduate teaching and research for which it has a world-wide reputation.
Web site: