Håkan Arheden

Håkan Arheden

Professor, consultant

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Research

My main research focuses are threefold: a) To understand and describe normal cardiac pumping; b) to understand and describe the pathophysiology of acute myocardial infarction; and c) to understand and describe the pathophysiology of heart failure, with the ultimate purpose to provide a faster and more accurate diagnosis which is a prerequisite for accurate treatment. Accurate treatment requires accurate diagnosis.

Disease is defined from the healthy state and normal function. A reasonable question is: Don’t we know enough about normal cardiac function to describe and understand cardiac disease? The answer is no. We aim to identify missing information about the healthy state in order to improve diagnosis and treatment for patients with heart disease.

Acute myocardial infarction is the most common cause of heart failure. We are investigating which mechanisms that are cardioprotective in the experimental setting that may not play out fully in patients. Both diagnosis and treatment of acute myocardial infarction has come a long way in the last decades. Standard treatment is timely opening of the occluded artery to restore blood flow to the myocardium at risk of infarction. Restoring blood flow, however, also leads to unwanted reperfusion injury. The holy grail in treatment of acute myocardial infarction is to prevent reperfusion injury. Several therapies, mostly pharmaceutical, have been successful in experimental infarction but failed in human trials. Mild hypothermia, meaning that the body temperature is lowered to 32-35°C before reperfusion, can almost prevent infarction completely in experiments. Results in humans, however, have been ambiguous.

Heart failure is one of the most common, most crippling, and costly diseases. It has hundreds of etiologies and appear in several variants. Heart failure is known to be difficult to diagnose in quantitative terms and challenging to treat. We have developed close to ten new methods to diagnose heart failure earlier and in a more quantitative way. These methods may detect heart failure earlier and provide more exact means to develop and monitor new treatments. We have validated most of them experimentally and clinically and we are now in the process of implementing them in studies of larger cohorts. Some are already implemented in clinical routine at Skåne University Hospital.

Our main research tool is magnetic resonance imaging (MRI) which has become the most versatile and powerful modality to measure macro- and microscopical physiology and pathophysiology in humans and animals. MRI provides quantitative information on anatomy, pumping, myocardial perfusion and tissue characteristics such as necrosis, healed infarction, fibrosis, cellular integrity, extracellular volume, etc. Single photon emission tomography (SPECT imaging) traces molecules in the body that provide information on perfusion of the heart and lungs. Echocardiography, exercise stress test with oxygen uptake, ECG, and blood testing for biobanking are other examples of methods to understand pathophysiological processes.

UKÄ subject classification

  • Clinical Medicine

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