Researchers at Emory and Georgia Tech have developed a method for predicting which areas of the coronary arteries will develop more atherosclerotic plaque over time, based on intracoronary ultrasound and blood flow measurements.
The method could help doctors identify "vulnerable plaque," unstable plaque that is likely to cause a heart attack or stroke. It involves calculating shear stress, or how hard the blood tugs on the walls of the arteries, based on the geometry of the arteries and how fast the blood is moving.
The results were posted online this week in the journal Circulation, published by the American Heart Association. The lead author is Habib Samady, MD, professor of medicine and director of interventional cardiology at Emory University School of Medicine.
Most people who have heart attacks do not have plaques in their arteries that bulge out and obstruct blood flow beforehand. Instead, the plaques in their arteries crack and spill open, leading to a clot. Samady says his team's ultimate aim is to try to figure out where that will happen.
Cardiology researchers studying arteries in isolation or in animals have long seen a link between branches in the arteries, disturbances in blood flow, and where atherosclerosis develops. The challenge was to translate observations from the laboratory to imaging the heart within a live person, he says.
"It's like looking at a river and predicting where sediment will accumulate," he says. "It sounds obvious, but it's hard to do it for every nook and cranny in the coronary arteries."
The Emory/Georgia Tech study was the largest published investigation of shear stress and plaque progression in humans so far, and the first to examine people with significant coronary artery disease. Doctors examined 20 patients in Emory University Hospital's catheterization laboratory between December 2007 and January 2009. They were being examined because they had abnormal exe
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