Researchers report important findings about African-American patients' hearts

Researchers at the Medical University of South Carolina are getting closer to figuring out why African-Americans are more likely to suffer and die from congestive heart failure than their white counterparts. It’s part of MUSC’s commitment to ending health disparities, which are preventable differences linked to race, ethnicity and socioeconomic status.

Joseph Schoepf, M.D., said doctors used to think the higher rate of heart problems among blacks could be explained by just looking at lifestyle and economic conditions. But his team’s research adds to the evidence showing that’s not the whole story.

“The analyses we have are actually pretty good in accounting for these factors, and even if you take everything into account, there’s still a substantial difference in cardiovascular disease incidence and prevalence between whites and blacks that can’t be explained by these factors,” Schoepf said. “So there has to be something else.”

That “something else” is what he and his colleagues want to get at, because it would allow doctors to detect problems early and prevent heart attacks. So in an international study, Schoepf and other researchers at MUSC, along with scientists in the Netherlands, Germany and Austria, used high-tech scans to explore what was happening in patients’ hearts. They looked at 300 patients, half of them black and half of them white.

MUSC was a good fit for the study, Schoepf said, because it serves a state where African-Americans make up a third of the population. The Austrian-born Department of Radiology professor, recognized as one of the top 10 cardiovascular imagers worldwide and as one of the most influential radiology researchers in the nation, directs cardiovascular imaging at MUSC. “We are obviously in the middle of one of the more diverse populations in the nation. It’s a population very well suited to this research, and that is combined with world-class imaging that we have here.”

The researchers’ conclusions, which appear online in the American Journal of Cardiology: Black patients who came in to hospitals to be treated for acute chest pain had larger heart mass, a slightly thicker wall separating the right and left sides of their hearts and a larger inner diameter of the left ventricle, which is the heart’s main pumping chamber. 

In other words, their hearts looked slightly different than those of their white counterparts, even after adjusting for age, gender, body mass index and hypertension. The culprit, researchers said, might be a combination of environmental and genetic factors.

Schoepf said more research is needed, but the study can have an immediate impact on patients. “We want to take the insights we’ve obtained and translate them into better delivery of health care. We want to make our advanced imaging tests that are unique here at MUSC Health widely available, especially to the populations who need it the most.” 

The MUSC Health Heart & Vascular Center was first in the country to get the CT industry’s most advanced technology, the SOMATOM Force scanner. It’s a powerful imaging test that provides detailed images of the heart and blood vessels. Part of its beauty is that it’s non-invasive – no need to put a tube up a patient’s groin like the old cardiac angiography tests did.

“We’re the only set up in a 500-mile radius in the Southeast that has this cutting-edge equipment,” Schoepf said. 

He wants people to know it’s available in Charleston through MUSC Health.

“That’s not restricted to a particular ethnicity or race,” Schoepf said. “Our goal is to make every part of the community aware of what we can do with our advanced imaging tests.

"We’re not saying everybody needs imaging. It’s for people with risk factors such as family history, or who know they have a lifestyle that‘s not completely healthy.”