Interviews
moving forward.
Interview with Dr Chris Miles
In this interview former CRY Research Fellow Dr Chris Miles discusses the arrhythmogenic cardiomyopathy research that he presented at EuroPrevent 2018 (“Sudden death and competitive sport in arrhythmogenic cardiomyopathy: A post-mortem study of young athletes”) that led to his Young Investigator of the Year award, and what his research aims are
Why did you choose to research arrhythmogenic cardiomyopathy in athletes?
suggesting that ACM affects the whole heart independently of changes that occur in the right ventricle during sustained exercise. What are the other key takeaways from your research? Over a third of young sudden death victims diagnosed with arrhythmogenic cardiomyopathy at expert post-mortem were engaged in competitive sport, principally sports with a high dynamic component such as football. Young athletes who had died suddenly from arrhythmogenic cardiomyopathy most often died during physical exertion, primarily while participating in their sport.
There is still much for us to learn about arrhythmogenic cardiomyopathy, in particular understanding more about why the condition arises and how it can be detected. This is especially relevant in young athletes, where competitive sport is an established trigger for heart rhythm disturbances.
They also had evidence of enlargement of the right ventricle alongside increased weight of the heart, consistent with the changes we see in the heart following prolonged athletic training.
Appearances of the diseased heart may also overlap with adaptive processes we see in the healthy athlete; it has been proposed that exercise may be enough to ‘trigger’ emergence of the condition in those with an underlying genetic susceptibility.
How did it feel to win the Young Investigator of the Year award at EuroPrevent?
Why is finding evidence of disease affecting the left ventricle so important?
I was deeply honoured to receive the Young Investigator Award in Sports Cardiology. This competition provides an excellent opportunity to Dr Miles with Professor Sharma present work at an international level and is well recognised by colleagues within the field.
The overwhelming majority of our arrhythmogenic cardiomyopathy sudden death group had evidence of disease involving the left ventricle, a significant finding given its classical description as a right ventricular disorder (arrhythmogenic right ventricular cardiomyopathy). There was also no difference in the presence of left ventricular involvement between young athletes and non-athletes,
I would like to thank my peers and supervisors Dr Elijah Behr and Professor Mary Sheppard, in addition to Cardiac Risk in the Young for its essential role in funding the CRY Centre for Cardiac Pathology. CRY is supported by hundreds of families affected by young sudden cardiac death and we hope to continue to make important progress into researching one of its important causes. What do you intend to focus on in your research next? I will continue my research into arrhythmogenic cardiomyopathy and also study the overlap with another rare disorder that affects the heart’s rhythm, Brugada syndrome. Dr Miles presenting his research at EuroPrevent 2018
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Research Highlights 2018
My PhD will investigate the pathological and genetic basis of these conditions.
Cardiac Risk in the Young