Heart Disease Detection Goes High Tech
Experts review the latest techniques that reveal whether you have heart disease.
Testing for MPO
Another key blood-based marker that may be available soon is myeloperoxidase (MPO). This is an enzyme in white blood cells that is linked to inflammation and CVD. Research has shown that an elevated blood level of MPO predicts the early risk of heart attack. MPO has been shown to be helpful in deciding if a patient's pain is related to heart disease.
Hazen says that "MPO looks like a great addition to risk screening in people who come to the hospital complaining of chest pain. And it seems to be a marker for vulnerable plaque." Vulnerable plaque refers to areas of thickening in the walls of arteries that are most likely to rupture and cause a heart attack or stroke.
A Glimpse of the Future
But in the future, blood tests may incorporate more than one marker in the hopes of creating a unique fingerprint of individual risk.
Gazing into his crystal ball, Hazen tells WebMD that "there won't be one single test in the future, but a blood-based array or panel to give the individual a snapshot of their long-term and near-term risks as well as which risks need to be worked on to help guide doctors in terms of where to focus risk-reduction efforts."
Aside from blood-based tests, improved imaging devices also hold enormous promise in screening for heart disease.
Traditionally, as with Clinton, doctors would use an angiogram to detect blockages in heart arteries. During a coronary angiogram, a thin, flexible tube called a catheter is inserted in a blood vessel, usually in the groin, and guided toward the heart. Then a dye is injected into the blood vessel to make it more visible on an X-ray. Complications are rare but can include stroke, damage to the arteries, or internal bleeding.
And these are some of the reasons that there is so much enthusiasm for the 64-slice computerized tomography (CT) scan. With this test, doctors can determine if there is calcium buildup in the heart arteries. While older multislice CT scans only allowed visualization of smaller parts of the heart, the 64-slice CT lets doctors visualize more. And computer processing yields a three-dimensional image of the arteries. This procedure eliminates the risk and discomfort associated with traditional angiograms, but there are the usual risks associated with exposure to X-radiation.
"The CT scan provides remarkably sharp images," Hazen says "The use of cardiac CT is going to explode. The images are spectacular."
Hazen isn't alone in his enthusiasm for this test. "The 64-slice CT scan is the most exciting new instrument we have," says Edward B. Diethrich, the founder and medical director of the Arizona Heart Institute in Phoenix. "The results we have seen in patient assessment and care are really fantastic."
Hazen does add that the 64-slice CT is not for everyone, "Data from the CT is acquired between beats so it doesn't provide as good of an image for people who are very large or who have an irregular heart rhythm or large calcifications in their arteries," he says.