Ask a Cardiologist series: We discuss Heart failure with Dr Joban Sehmi

Wednesday, January 15, 2020

We recently caught up with leading Cardiologist Dr Joban Sehmi as part of our 'Ask a Cardiologist' series to get his thoughts on some important questions surrounding heart failure. Here's what he had to say:

What in your opinion is the best modality to assess for CCF?

Imaging techniques play an important role in heart failure diagnosis, assessment of aetiology and treatment guidance. Echocardiography is the method of choice for its availability, cost and it provides most of the information required for the management and follow up of HF patients.

Other non-invasive cardiac imaging modalities, such as cardiovascular magnetic resonance, nuclear imaging-positron emission tomography and single-photon emission computed tomography and computed tomography provide additional aetiological, prognostic and therapeutic information. Each individual technique has strengths and weaknesses, and in an era of multi-modality imaging, these individual strengths need to be harnessed to help achieve a precise and accurate diagnosis.


In your opinion what could be done differently to aid the accurate diagnosis and treatment of heart failure patients?


Heart failure is common; one in five people will develop it at some point, and prevalence increases with advancing age. Vast majority of patients with heart failure are identified during an emergency admission within secondary care. The high numbers of hospitalisations for heart failure place a substantial burden on healthcare systems. Given the massive constraints and pressures placed on secondary care, it is imperative patients be identified early before they decompensate. This can be achieved through greater awareness and wider use of Blood Natureitic Peptide (BNP) blood test amongst primary care physicians to diagnose heart failure early when patients present with mild symptoms.

This facilitates prompt referral for echocardiography, thereby allowing early medical intervention with the hope of preventing unnecessary hospital admissions.


How do you feel about AI and how this could affect Cardiology?


Artificial intelligence (AI) is a rapidly evolving field in medicine, and is defined as the ‘theory and development of computer systems able to perform tasks normally requiring human intelligence’. By creating algorithms using a variety of neural networks, dynamic deep machine learning mimics the human brain by using large high-quality data sets to create layers of neural networks to generate automated predictions, interpret image data and develop pattern recognition. AI aims to aid health care professionals to make better decisions, improve workflow, productivity, and cost-effectiveness and ultimately patient outcomes.

There are several applications, particularly in cardiac imaging. AI is already being applied in CT fractional flow assessment and volumetric assessment using MRI. Echo lends itself well to AI, with extensive work being carried out in areas such as automation of valve assessment, LV function measurement and detection of regional wall motion abnormalities.


As imaging Consultant what career progression advice would you give to physiologists?


A good way to accelerate career progression is to actively participate in clinical research and quality improvement projects. The best way to ensure your work is appropriately validated is to present your data at national/ international conferences and potentially have it published in a peer-reviewed journal.


ICS Diagnostics is a passionate team of industry leaders driving for innovative change within healthcare diagnostics. We understand the various issues facing the healthcare diagnostics industry, the root causes, and want to bring real positive change.

Follow us on LinkedIn for our latest news or contact us for more information.