Doctors need better ways to detect and monitor heart disease, the leading cause of death in industrialized countries. A team led by Massachusetts General Hospital researchers with support from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) has developed an improved optical imaging technique that found differences between potentially life-threatening coronary plaques and those posing less imminent danger for patients with coronary artery disease. Their method may give cardiologists additional data to identify patients at higher risk of future heart attacks and help them improve medical therapy.
drawing of blood vesselsFigure A shows blood flow through a normal artery. Figure B shows an artery with plaque buildup. Source: NHLBI.
Coronary artery disease is the most common type of heart disease in the United States. It is caused by deposits of atherosclerotic plaques within coronary arteries that supply blood to the heart muscle. Atherosclerotic plaques are accumulated, lipid-rich (fatty) material and calcifications in the vessel wall, and cause the inside of the arteries to stiffen and become restricted over time.
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The most common symptom of coronary artery disease is angina, which causes chest pain or discomfort during physical exertion because the plaques restrict blood flow and oxygen supply to the heart muscle. Also called stable angina pectoris, this condition may weaken heart function over time, but does not usually cause a sudden heart attack. But when the fibrous cap covering a lipid filled atherosclerotic plaque ruptures and releases the plaque content into the vessel, a blood clot can result that blocks the coronary artery and causes a heart attack. This abrupt, life-threatening condition is called acute coronary syndrome. Cardiologists would like to be able distinguish stable coronary plaques from those prone to rupture.
“This research relies on the latest optical imaging techniques to systematically categorize plaques as indicators of coronary artery disease,” said Behrouz Shabestari, Ph.D., director of the NIBIB program in Optical Imaging and Spectroscopy. “The technique could be a game changer for cardiologists and their patients, offering refined insight into coronary arterial atherosclerotic lesions with quantifiable imaging data.”
The research team is led by Brett Bouma, Ph.D., professor of dermatology and health sciences and technology, Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston. In a study published in the Aug. 8, 2019 issue of JACC: Cardiovascular Imaging, Bouma’s team investigated the polarization properties of coronary atherosclerotic plaques in 30 patients with coronary artery disease, searching for indications of plaque instability. They gathered data using intravascular polarimetry, a technique for assessing the polarization properties of cross-sections of vascular tissue.