National Heart Centre Singapore unveils pioneering Centre for Advanced Metabolic Imaging launched by Mr Goh Chok Tong, Emeritus Senior Minister at the 5th NHCS Heart to Heart Gala 2024
image: Click here for hi-res version of the above image.
Credit: National Heart Centre Singapore
Singapore, 15 November 2024 – Mr Goh Chok Tong, Emeritus Senior Minister, launched the National Heart Centre Singapore’s (NHCS) new Centre for Advanced Metabolic Imaging (CAMI) at the 5th NHCS Heart to Heart Gala on 15 November 2024 at The Ritz-Carlton, Millenia Singapore. The CAMI is a state-of-the-art research facility that sets to revolutionise the study of metabolic health and its profound impact on heart disease.
A Timely Response to Singapore’s Growing Health Challenges
With obesity and diabetes on the rise in Singapore1, the burden on public health is immense, both in terms of quality of life and economic costs. These conditions are linked to cardiovascular diseases, which remain a leading cause of death in Singapore. The launch of CAMI represents a significant leap forward to tackling this pressing issue. By providing insights on how metabolic disorders and fat accumulation affect cardiovascular health, CAMI will enable clinicians and researchers to develop targeted interventions for preventing and treating heart disease in Asians.
CAMI addresses a critical gap in current diagnostic tools. Traditional metrics like body mass index (BMI), often fail to accurately reflect an individual’s risks of developing cardio-metabolic diseases. While BMI is widely used, its limitations are evident, especially for Asians. Research shows that up to 20% of Asians with diabetes have a "normal" BMI range, compared to just 5% of Caucasian populations2. This alarming discrepancy underscores the urgent need for more advanced and nuanced assessments.
Key Features and Roles of CAMI: A New Frontier in Understanding Fat Distribution and Metabolic Health
By harnessing cutting-edge imaging technologies, CAMI will redefine how obesity and metabolic disorders are assessed. CAMI’s innovative approach enables researchers to map fat deposition and analyse organ metabolism with precision, providing insights into the relationship between obesity, metabolic health and cardiovascular.
1. Cutting-Edge Technology
- Magnetic Resonance Imaging (MRI)
CAMI utilises advanced MRI techniques to provide high-resolution images that enable detailed analysis of fat distribution throughout the body. This is essential for identifying specific areas of fat accumulation, including visceral fat surrounding vital organs, which have been closely linked to an increased risk of cardiovascular disease. Studies at CAMI will focus on the unique fat distribution patterns of Asian populations, which differ significantly from those seen in other ethnic groups.
- Carbon-13 (C-13) Hyperpolariser
The C-13 Hyperpolariser is a revolutionary breakthrough in metabolic imaging, enhancing the sensitivity of metabolic measurements by more than 10,000-fold. This advanced technology allows real-time tracking of how the body metabolises sugars into energy, offering unprecedented insights into metabolic pathways and pinpointing how different organs process nutrients into energy.
With CAMI being among fewer than 20 global sites – and the first in Southeast Asia –equipped with this technology, it positions NHCS at the forefront of metabolic research.
Refer to Annex A for details on CAMI facility.
2. Asian Patient-Centric Focus
Many of the current research findings are focused on the Western population and often extrapolated to the Asian population despite differences in genetic make-up and lifestyle differences which limits generalisability.
CAMI’s research aims to change this and will prioritise on the unique metabolic profiles of Asian populations, where traditional health models often overlook serious risks. Take for example, many Asians, despite having a “normal” BMI, are at increased risk for conditions like fatty liver disease, diabetes, and heart disease. By translating cutting-edge research into eventual clinical practice, CAMI aims to develop tailored interventions that address these unique metabolic risks, significantly improving health outcomes for Asian individuals at risk of obesity, diabetes, and cardiovascular disease.
Refer to Annex B for case studies.
3. Pioneering Clinical Research with Global Impact
CAMI has already begun its pioneering studies on healthy volunteers, using its C-13 Hyperpolariser and advanced MRI systems. These studies will soon extend to patients with diabetes and obesity, investigating the metabolic changes that drive cardiovascular health risks. This pioneering research has the potential to reshape the understanding of cardio-metabolic diseases, influencing treatments not only in Singapore but globally.
CAMI: A Gamechanger in Cardiovascular and Metabolic Research
"Our commitment at the Centre for Advanced Metabolic Imaging is to deepen our understanding of metabolic health in Asian populations. By doing so, we can create targeted strategies to combat cardio-metabolic diseases and improve patient outcomes,” said Associate Professor Calvin Chin, Senior Consultant and Clinician Scientist, Department of Cardiology, NHCS. Assoc Prof Chin is also Director, Cardiac Magnetic Resonance Imaging, and Deputy Director, National Heart Research Institute Singapore (NHRIS), NHCS.
"With the launch of CAMI, NHCS reinforces our commitment to tackling diabetes and heart disease through continuous innovation and research. We believe that CAMI will provide breakthrough insights and pave the way for new, personalised treatments that improve health outcomes for patients in Singapore and beyond," said Prof Yeo Khung Keong, Chief Executive Officer, NHCS.
CAMI’s mission extends beyond diagnosis – it aims to reshape the understanding and treatment of metabolic diseases. CAMI will serve as a hub for groundbreaking research, bringing together world-leading researchers and clinicians to collaborate on finding novel strategies for prevention, diagnosis, and treatment. With its focus on the unique metabolic challenges faced by Asian populations, CAMI is set to become a critical driver of innovation in cardiovascular care.
The setup of CAMI has been made possible with various philanthropic support, including those made in the name of the Anjuman & Aziz Charitable Trust, as well as from our collaborators such as the Agency for Science, Technology and Research (A*STAR), SingHealth and Duke-NUS Medical School.
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About the National Heart Centre Singapore
The National Heart Centre Singapore (NHCS) is a leading national and regional referral centre for cardiovascular diseases, offering 185 beds and a comprehensive range of cardiac care services from preventive to rehabilitative. Ranked #12 as the World’s Best Cardiology Hospital by Newsweek 2025, NHCS’s clinical outcomes are consistently recognised at the international level, meeting or exceeding global standards. It is also the only facility in Singapore providing heart transplantation programme.
As an academic medical centre, NHCS is committed to training healthcare professionals and advancing cardiovascular health through cutting-edge translational research in collaboration with local and international collaborators.
For more information, please visit: www.nhcs.com.sg
About the NHCS Heart To Heart Gala
The NHCS Heart To Heart Gala is a signature biennial fundraising event aimed at supporting needy heart patients, advancing innovations in cardiovascular research, and nurturing the next generation of healthcare professionals. Inaugurated in 2015, the prestigious event brings together philanthropists, corporate partners, and healthcare staff to champion the fight against heart disease. Funds raised go towards novel initiatives that improve patient outcomes and strengthen Singapore’s position as a leader in cardiovascular care. The Heart to Heart Gala underscores NHCS’s commitment to providing world-class heart care while shaping the future of cardiovascular medicine.
For more information, please visit: NHCS Heart To Heart Gala
Annex A
The Centre for Advanced Metabolic Imaging (CAMI) at the NHCS is a pioneering research facility, equipped with state-of-the-art technologies designed to revolutionise the study of cardio-metabolic diseases. Through the integration of advanced magnetic resonance imaging (MRI) techniques and the groundbreaking Carbon-13 Hyperpolariser, CAMI aims to deepen our understanding of fat distribution and metabolism in the body, particularly in Asian populations.
Click here to view the hi-res introductory video on CAMI.
Click here to view the hi-res launch photos taken at the 5th Heart to Heart Gala on 15 November 2024. (Photos will go live by 9am EST, 15 Nov)
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Magnetic Resonance Imaging (MRI) |
MRI is a non-invasive, radiation-free imaging technique that provides detailed insights into the body’s internal structures. At CAMI, MRI technology is utilised to:
- Visualize and measure fat distribution with precision
- Differentiate between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), which play vastly different roles in metabolic health
- Assess specific fat volumes in targeted areas, allowing researchers to quantify fat deposits that are most closely linked to obesity-related diseases like diabetes and heart disease
- Study the impact fat distribution on heart structure and function
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Carbon-13 (C13) Hyperpolariser |
The Carbon-13 (C-13) Hyperpolariser is one of CAMI’s most advanced and significant tools, marking a breakthrough in metabolic imaging. This technology enhances the signal of C-13 nuclei by over 10,000 times compared to conventional imaging methods, allowing for real-time, non-invasive tracking of how the body metabolises sugars into energy. Key capabilities include:
- Real-time metabolic tracking: The C-13 Hyperpolariser enables researchers to observe the metabolism of biomolecules like pyruvate, a critical compound involved in energy production.
- Precision and safety: Unlike traditional imaging techniques to assess metabolism, such as PET which rely on radiation, the C-13 Hyperpolariser provides metabolic insights without exposing patients to harmful radiation, making it ideal for repeated studies.
- Insights into regulation/dysregulation of metabolic pathways: By revealing how different organs utilise energy, this technology can identify key metabolic disruptions in conditions like diabetes, obesity, and heart failure. It also has the potential to revolutionise the diagnosis and monitoring of ischemic heart disease, offering insights into how well treatments are working in real time.
Annex B
The case studies below demonstrate how CAMI’s advanced imaging technologies can provide critical insights into the diverse ways fat is distributed in the body and how these differences can potentially impact metabolic and cardiovascular health.
Case study 1
Patient: Ms. Tan, 55-year-old female
Medical History: Well-controlled hypertension, with no diabetes
BMI: 22.5kg/m2 (normal range)
Ms. Tan’s MRI scans revealed a VAT/SAT ratio of 0.44, indicating that she has an elevated amount of subcutaneous fat (SAT) compared to visceral adipose tissue (VAT). Notably, there was no evidence of fat accumulation in the liver, and her overall fat distribution suggested that she carries more fat beneath the skin rather than around internal organs. Her function and structures were normal.
Case study 2
Patient: Mr. Chan, 65-year-old male
Medical History: well controlled hypertension and diabetes (HbA1c 7.3%)
BMI: 22.8kg/m2 (normal range)
Unlike Ms. Tan, Mr. Chan’s MRI scan revealed a VAT/SAT ratio of 2.1, indicating a significant accumulation of visceral fat relative to subcutaneous fat. In addition, Mr. Chan showed evidence of fat accumulation in the liver, known as fatty liver disease, as well as increased epicardial fat (fat around the heart). Moreover, there was also evidence of scarring in the heart muscles that might be related to his underlying metabolic risk. Although normal now, this risk could increase his likelihood of heart complications later in life.
Mr. Chan’s case illustrates a phenomenon where an individual may have normal BMI yet possess a significant amount of internal fat, known as visceral fat, which typically does not affect the physical appearance until later stages. This creates a false sense of good health, placing individuals like Mr Chan at an even higher risk of cardio-metabolic complications.