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#IHeartResearch: On a mission to help cardiac patients

Heart beat

Dr Dan Knight is passionate about research for patient benefit.

A clinical cardiologist who has an academic component to his job, Dr Knight is interested in how magnetic resonance imaging, often called MRI, can help to better diagnose and manage pulmonary hypertension.

MRI uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. Pulmonary hypertension (PH) is a rare disease of high pressure in the blood vessels that deliver blood from the heart to the lungs, the pulmonary arteries. It is a serious condition that can cause the right side of the heart to fail. Dr Knight specialises in cardiac MRI and PH at the Royal Free London NHS Foundation Trust, and has combined his interests in these two fields in his research work.

Dr Knight said: “The opportunity to improve the health of others is an admirable reason that is given by a large proportion of patients who volunteer to take part in trials. However, research also offers the potential for individual patient benefits too. These include access to the latest healthcare diagnostic and treatment developments, and close medical follow-up from the clinical trials team.”

Dr Knight, who has recently been appointed CRN North Thames Cardiovascular Disease Specialty Lead, is specifically interested in how MRI can guide heart catheterisation to assess the pressures in the right side of the heart and lungs more accurately. Right heart catheterisation is a diagnostic technique in which a thin tube called a catheter is inserted in a vein in your groin, neck or arm and threaded through your blood vessels to your heart and lungs.

He said: “CMR (Cardiac Magnetic Resonance) is a valuable imaging technique for the investigation and management of patients with PH. It provides highly accurate measurements of right heart size, function and mass, all of which help us get a sense of the prognosis for PH patients. However, we still need to use catheterisation to manage PH in the best way. Combining the two techniques offers us great potential to look at how the heart and lungs interact with one another in PH in more sophisticated ways.”

Dr Knight started the MR-guided right-heart catheterisation clinical academic programme at Royal Free in late 2017, and has been involved in several clinical trials. This includes one known as MR-cardio-pulmonary exercise testing (or MR-CPET), which looks at the complex relationship between the heart, lungs and muscles and how this relates to patients’ symptoms of breathlessness. He has also given presentations at international CMR conferences.

Dr Knight has enjoyed strong support from CRN North Thames, which encouraged him to apply for the role of Specialty Lead.   

He explained: “My MR-CPET study is adopted to the CRN portfolio which has in turn offered me a platform to promote our research activity and encourage recruitment of a rare disease patient cohort.

Furthermore, CRN funding has enabled continued recruitment for research nurses who are crucial to facilitating our portfolio of cardiovascular research studies at the Royal Free London NHS Foundation Trust.

“I would identify myself as an early career researcher (ECR) and I have experienced some of the barriers to research delivery in that role. The NIHR offers a range of benefits to ECRs such as training advocates, career development support, free Good Clinical Practice training and access to ECR networks. I hope to promote local ECR engagement in NIHR CRN activities in our region and offer my experience to help push forward this key objective of the CRN North Thames.”

Clinicians interested in engaging with research should visit the NIHR’s Your Path in Research page to learn more.