An interview with Dr Sabiha Gati on being a CRY Fellow and her research

In the medical community around the world, CRY is best known for research. Our research has helped transform our understanding of young sudden cardiac death, the conditions that cause it, and how we can save more young lives.

Our Research Fellows have been instrumental in our developments over the years, so we spoke with former CRY Research Fellow Dr Sabiha Gati about what her work with CRY involved, her research, and how her career has advanced since her time with the charity.

“The CRY research fellowship was well sought after, a 3-year funding program to do research, and was recommended,” Dr Gati said when looking back at when she first joined CRY. “During my cardiology training, I had been working at University hospital Lewisham and I was very much involved with the CRY clinics. I had been working as a clinical registrar alongside the previous CRY fellows and very much involved with actively helping them their research projects. I did their research echocardiograms as part of my training and simultaneously got to interact with the parents whose children had suffered a sudden cardiac death. I was heartened by their ordeal and their natural instinct to protect their surviving children and how they managed their family. CRY was fantastic in the way they supported the family and the whole screening process. I felt I could make a significant impact with my skills and abilities; I appreciated the significant work CRY were doing and I wanted to be involved as a young professional supporting this very important cause.”

Early on as a Fellow, Dr Gati attended family screenings where she helped examine results and spoke with those being tested.

“I was involved with monthly cardiac screening where I got to travel all over the UK for weekend family screening, meeting the families and making a difference to young people cardiac health,” Dr Gati recalls. “Simultaneously, my fellowship coincided with the 2012 UK Olympics and CRY were also involved with cardiac screening of the British Olympic athletes which was a really exciting project to learn about the athletic remodelling and the impact of exercise on changes to cardiac structure and how it overlaps with inherited heart muscle conditions.

“We did specialist inherited cardiac conditions clinics at St George’s Hospital for patients with electrical and structural issues including acropathies. This also included individuals referred via the CRY screening program. During clinic, I was involved with the clinical assessment, risk stratification and management of individuals with inherited conditions and this had a real impact as I really felt I was making a difference to their life.

In addition to working with screening, Dr Gati completed her own research. She has studied a variety of cardiac conditions, including left ventricular non-compaction.

“Given this was a research fellowship I was also involved with setting up my research in the field of inherited cardiomyopathies and actively recruiting, investigating and managing the research data acquired from my study. The perks of being a Research Fellow provided the opportunity of attending international conferences networking, presenting out data and placing CRY on the global map.”

“I researched an inherited heart muscle condition called left ventricular non-compaction which causes a spongy appearance and has serious consequences including heart failure and sudden death,” Dr Gati explains. “My previous research in athletes had shown that around 8% of athletes also showed features that could be compatible with the condition on the echocardiogram and this made me realise that not all people with a spongy appearance of the heart could be considered to have a serious condition. I had hypothesised that increasing the load on the heart for a prolonged period such as regular intensive exercise may also cause the spongy appearance.

“I used a pregnancy model to prove this hypothesis. Pregnancy is associated with doubling of the cardiac blood volume by the end of the second trimester. I performed a longitudinal study using cardiac ultrasound in 102 pregnant women in the first and third trimester and post pregnancy period. All women had structurally normal hearts without any spongy appearance at the beginning. During pregnancy 26 women developed the spongy appearance. In the post-pregnancy period 19 women showed resolution of the spongy appearance and 6 had near resolution. As they say, pregnancy is like running a marathon. The finding from this study should prevent erroneous over-diagnosis of left ventricular non-compaction in low risk populations. My research has had a significant impact in the way we diagnose these conditions. The work generated several abstracts, publications, oral presentation and prizes internationally.”

At our Family Research Day in 2019, Dr Gati gave a presentation to talk about exactly what it means to be a CRY Research Fellow:

After completing her time as a Fellow, Dr Gati has gone on to further her work in cardiology, help CRY’s myheart network, and currently works at the Royal Brompton Hospital in London as a Consultant Cardiologist.

“A typical day will involve assessing and supporting patients in the inherited cardiac conditions clinic with genetic cardiac diseases,” Dr Gati says. “I have also set up a sports cardiology clinic to support individuals who wish to participate in sport be it at a recreational or competitive level with cardiovascular diseases. I love the idea that I can give my patients advice on a healthy lifestyle and exercise prescription as part of preventive medicine. My other interest is to provide specialist imaging of the heart with cardiovascular magnetic resonance to identify patients with coronary artery disease and heart failure which are the leading killers in the aging population. I am actively involved in teaching junior doctors and lecturing at national and international level. My research interest parallel my clinical interest and I continue to support CRY through ‘advice and guidance’ service, the myheart network, and the international CRY conference. This year we will be appointing the first CRY Fellow to work alongside me at the Royal Brompton to do valuable research and train in the field of inherited cardiac conditions.”

CRY’s research programme has constantly developed over the years, with numerous influential studies being published as our understanding of young sudden cardiac death has grown.

We have had a total of over 30 Research Fellows over the years, who have been trained as specialists by CRY, completed a wealth of impactful research, and are now working in the NHS throughout the UK, while many more have received international grants to return to hospitals around the world. And before the COVID-19 pandemic brought screening events to a halt, we had screened over 220,000 young people.

“CRY research has made a massive impact to preventing young sudden cardiac death,” Dr Gati says. “In the UK only young people with cardiac symptoms or a family history or premature cardiac disease or sudden cardiac death receive cardiac screening on the NHS. However, most deaths occur in the absence of symptoms. CRY research has shown that 1 in 300 young people in the UK have a potentially serious cardiac condition. The CRY screening program has continued to expand which has only been possible through the valuable support of the fundraiser and sponsors. I would say that CRY have made a difference to a young person’s life through supporting the training of individuals like myself who now work all over the UK supported and managing specialist inherited cardiac conditions clinics.

“CRY is my charity, and I am for one very proud of what they have achieved!”