April 24, 2012

New technique could improve heart attack prediction

Woman lying in hospital bedWe’ve funded an award-winning research project that could improve how doctors predict a person’s risk of heart attack.

Our scientists have, for the first time, combined two medical imaging technologies called positron emission tomography (PET) and computerised tomography (CT) to look at the processes in coronary heart disease (CHD) that lead to a heart attack.

The researchers, who are based at the University of Edinburgh – a BHF Centre of Research Excellence, demonstrated the potential of using PET and CT scanning to look directly into the walls of the arteries that supply blood to the heart. If these arteries become blocked, it can cause a heart attack. CHD kills 88,000 people in the UK each year; most of these deaths are caused by a heart attack.

Current ways of looking for heart disease

This research is a technical tour de force

People experiencing chest pain are often given a calcium CT score – a standard test that shows the amount of calcified or hardened plaques building up in the arteries. The score is used to assess the likelihood this pain is caused by CHD but it cannot show the difference between calcium that’s been there for some time and calcium that’s actively building up.

The new technique

The scientists, working in collaboration with the University of Cambridge, gave over 100 people a calcium CT score. They then used specialist PET scans to show areas where calcium was building up. They think that arteries with active calcium build-up may be those with plaques more likely to cause a heart attack.

Dr Marc Dweck, who led the research and is one of our Clinical Research Fellows, said:

“If we can identify patients at high risk of a heart attack earlier, we can then use intensive drug treatments, and perhaps procedures such as stents, to reduce the chances of them having a heart attack.”

Dr Shannon Amoils, our Research Advisor, said:

“For decades cardiologists have been looking for ways to detect the high-risk plaques found in coronary arteries that could rupture to cause a heart attack, but it’s been difficult to develop a suitable imaging test that can focus in on these small vessels.

"This research is a technical tour de force as it allows us to assess active calcification happening right in the problem area – inside the wall of the coronary arteries and this active calcification may correlate with a higher risk of a heart attack."

Dr Dweck received two international awards for this research: the William W Parmley Young Author Award and the Young Investigator Award by the Journal of the American College of Cardiology (JACC) and the American College of Cardiology, respectively. He is also using this imaging technology to improve our understanding of the valve disease, aortic stenosis.

This research is published in the medical journal JACC.