Ultrasound Technology Aimed at Detecting Dangerous Plaque, Predicting Heart Attacks
An advanced ultrasound technology developed by a team of Cleveland Clinic scientists allows cardiologists to detect patients at high risk for heart attacks by determining where dangerous plaques are developing within their coronary arteries.
Three-dimensional reconstruction of human coronary artery showing plaque composition: yellow = fibrous, green = fibrolipidic, red = necrotic, purple = calcium
The new technology analyzes ultrasound radiofrequency wavelengths to determine the types of tissue composing arterial plaques. Rupture of atherosclerotic plaque is a major cause of heart attacks. When atherosclerotic plaque bursts open, cholesterol-laden lipid content spills into the artery. This spill, in turn, can cause blood clots and heart attacks.
D. Geoffrey Vince, Ph.D. , Department of Biomedical Engineering, led studies that compared the tissue structure of coronary arteries, especially plaque-lined arteries, with the radiofrequencies that bounced off each type of tissue. Dr. Vince and his colleagues used the information to build a database of the various topographies found inside coronary arteries. Next, using a system of analysis known as autoregressive classification, Dr. Vince’s group built onto existing ultrasound technology by designing a system that creates a three-dimensional analysis of tissue composition throughout the coronary artery.
“Diagnosis of critical trouble zones inside coronary arteries can be performed in real time while patients undergo coronary catheterization,” explained Dr. Vince, whose research was published in the Oct. 22 issue of Circulation. “This will enable physicians to respond immediately to the otherwise undetectable life-threatening heart artery plaque build-up.”
Dr. Vince’s method of vulnerable plaque diagnosis is 85.5 percent accurate in finding calcified necrotic regions and 81.2 percent accurate in classifying fibrolipidic regions in coronary arteries. When a vulnerable plaque erupts to cause a heart attack, the fibrous surface of the plaque breaks, allowing the necrotic and lipid-rich matter inside to flow into the blood within the artery. Blood cells clot when they come in contact with these contents. The clotting of blood within a coronary artery is characteristic of heart attacks.
Previous existing technologies are vastly insufficient in predicting the location and composition of potentially dangerous plaques in patients during surgery room procedures involving heart catheterization. Non-invasive technologies, such as magnetic resonance imaging and CAT scans, remain limited by lower resolution in the accuracy of analysis and diagnosis of coronary artery disease.
Eric Topol, M.D. noted the potential impact Dr.Vince’s technology offers clinicians in providing avenues of proactive care for patients at risk for heart attacks.
“This is a very important study in the field as we move forward in anticipating which arteries, which patients are destined to develop heart attacks,” Dr. Topol said. “It enables cardiologists to guide sophisticated preventive therapies.”
The technology stems from collaborations between Lerner Research Institute biomedical engineers: D. Geoffrey Vince, Ph.D., and Barry Kuban, B.S.; Case Western Reserve University graduate student Anuja Nair, M.S.; and Cleveland Clinic cardiologists: E. Murat Tuzcu, M.D., Paul Schoenhagen, M.D., and Steven Nissen, M.D.
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