Featured Research

from universities, journals, and other organizations

Cardiac imaging breakthrough helps determine diminished blood flow to the heart

Date:
June 22, 2010
Source:
Society of Nuclear Medicine
Summary:
Research is challenging the typical paradigm used to determine whether heart patients will benefit from invasive procedures like stent-placement or open-heart surgery.

Research presented at the Society of Nuclear Medicine's 57th Annual Meeting is challenging the typical paradigm used to determine whether heart patients will benefit from invasive procedures like stent-placement or open-heart surgery.

Current medical practice favors treating patients with coronary atherosclerosis (or hardening of the artery walls due to plaque build-up) with such procedures if a coronary artery is shown to be blocked by 70 percent or more in order to reduce symptoms and potentially prevent heart attack. However, a group of cardiac investigators are now finding that in addition to the degree of blockage, composition of the plaque causing the blockage also has significant impact on coronary artery blood flow. This may help explain why two people with similarly blocked coronary arteries can experience vastly different symptoms.

"If we can determine certain characteristics of the coronary artery plaque, we can predict whether a patient's symptoms are due to limitation of blood flow to the heart," said Haim Shmilovich, M.D., principal author of the study and a cardiac CT/MRI fellow-cardiologist at the Cedars-Sinai Medical Center, Los Angeles, Calif. "With further studies, our findings may change treatment planning for patients with severe but stable coronary artery disease by helping us determine which patients could be treated just as effectively with medications and lifestyle changes, thereby avoiding unnecessary invasive angioplasty and bypass surgery."

Shmilovich and colleagues used two imaging procedures: coronary CT angiography (CCTA) -- which reveals the composition of coronary artery plaque and the degree of blockage it causes -- and myocardial perfusion imaging (MPI) -- which measures relative blood flow to different regions of the heart. The investigators found that clinicians can more accurately determine a patient's risk of having reduced blood flow to the heart muscle by identifying three plaque characteristics: the presence of a fatty core, signs of spotty calcifications and enlargement of the arterial wall from "positive remodeling," which means the body has responded to arterial damage by altering the structure of the artery. Either individually or combined, the presence of these characteristics in diseased arteries can predict diminished blood flow to the heart muscle, which could lead to symptoms, including heart attack.

For this study, 34 patients without known coronary artery disease were imaged using CCTA and MPI to determine the presence of adverse plaque characteristics (APCs) and blood flow. Length of time between scans was limited to six months without any interval change in patients' symptoms or treatment. All patients had severe (70 to 89 percent) blockage in the beginning or middle section of a major coronary artery on CCTA. APC evaluation on CCTA was performed by a blinded third-party expert, and MPI evaluation was conducted through automated computer-based validated analysis. Results indicated that slightly more than 38 percent of all patients had significant ischemia, i.e., significantly limited blood flow to the heart muscle, when imaged with MPI. In the arteries with plaques that showed a fatty core, significant ischemia of the heart muscle portion nourished by the affected artery occurred at a much higher and statistically significant frequency (80 percent) than those without a fatty core (21 percent). Finding multiple APCs in a plaque was also associated with higher degrees of significant ischemia.

According to 2010 data from the American Heart Association, more than 81 million Americans -- or more than one in three -- have some form of cardiovascular disease. Major modifiable risk factors for heart disease include high blood-cholesterol levels, hypertension, diabetes, smoking and sedentary lifestyle.

Scientific Paper 430: H. Shmilovich, VY. Cheng, BK. Tamarappoo, D. Dey, PJ. Slomka, DS. Berman, Cardiac Imaging Department, Heart Institute, Cedars-Sinai Medical Center, Los Angeles, Calif.; "Adverse characteristics in coronary arterial plaques causing severe stenoses on coronary computed tomography angiography predict inducible ischemia on myocardial perfusion imaging," SNM's 57th Annual Meeting, June 5-9, 2010, Salt Lake City, Utah.


Story Source:

The above story is based on materials provided by Society of Nuclear Medicine. Note: Materials may be edited for content and length.


Cite This Page:

Society of Nuclear Medicine. "Cardiac imaging breakthrough helps determine diminished blood flow to the heart." ScienceDaily. ScienceDaily, 22 June 2010. <www.sciencedaily.com/releases/2010/06/100607141959.htm>.
Society of Nuclear Medicine. (2010, June 22). Cardiac imaging breakthrough helps determine diminished blood flow to the heart. ScienceDaily. Retrieved October 22, 2014 from www.sciencedaily.com/releases/2010/06/100607141959.htm
Society of Nuclear Medicine. "Cardiac imaging breakthrough helps determine diminished blood flow to the heart." ScienceDaily. www.sciencedaily.com/releases/2010/06/100607141959.htm (accessed October 22, 2014).

Share This



More Health & Medicine News

Wednesday, October 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
CDC Revamps Ebola Guidelines After Criticism

CDC Revamps Ebola Guidelines After Criticism

Newsy (Oct. 21, 2014) The Centers for Disease Control and Prevention have issued new protocols for healthcare workers interacting with Ebola patients. Video provided by Newsy
Powered by NewsLook.com
WHO: Ebola Vaccine Trials to Start a in January

WHO: Ebola Vaccine Trials to Start a in January

AP (Oct. 21, 2014) Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe in soon to start trials, the World Health Organization said Tuesday. (Oct. 21) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins