New device can spot blocked arteries

February 16, 2009 7:36:20 PM PST
There are sophisticated tests to spot blocked arteries and a new generation of drugs to help combat the danger. But now, some Bay Area doctors have begun using a test that could provide an early warning -- months or even years before a patient is likely to suffer a heart attack or stroke.

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Strolling down the street in Petaluma, Marianne McIsaac barely looks her age of 50 -- let alone 72.

"It was an eye-opener that's for sure," said McIsaac.

But according to a test she had done last year, that was the statistical age of her arteries.

"If this was narrowed to a 20-percent opening, you might have to have carotid surgery," said Dr. David Chappel.

Dr. Chappel is one of a number of Bay Area doctors now using a sophisticated ultrasound technology called Arteriovision, which until recently was mainly used as a search tool.

"I think its main utility is to pick up high risk people, high risk for stroke or heart attack who don't know it," said Fr. Chappel.

That includes patients like Marianne, who has low cholesterol, and none of the other common risk factors associated with heart disease.

In a follow up test, a technician scans Marianne's carotid artery. Unlike normal ultrasound, this system uses software, designed to measure the thickness of the arterial wall.

The arterial age is judged by comparing the thickness to averages compiled in a statistical database. Dr. Chappel says the thicker the walls, the more susceptible the artery is to damage.

"The thickness of the lining would correlate with a tendency for plaques and when you have plaque it builds up to the point it ulcerates and you have piece flips off or it blocks whole blood flow and you have a heart attack or stroke," said Dr. Chappel.

The device is approved by the fda, but it's not typically covered by insurance. The cost of a scan is in the $280 range.

Some researchers question the value of the test. Dr. Byron Lee is a professor of cardiology at UCSF.

"There is no definitive proof that there's any value in it right now, because there aren't strong outcome data to support that it actually changes your actually likely to get a heart attack," said Dr. Lee.

Dr. Chappel admits the thickened arteries are not necessarily an immediate threat unless they begin to close, but he argues the reading does provide an early warning.

And in cases like Marianne's a combination of medication and lifestyle changes, can sometimes reverse that thickening.

"Made me realize whatever you look like on the outside, different thing can be going on the inside," said McIsaac.

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