LOS ANGELES (December 16, 1998) -- Heart Watch, a new cardiac program that features a coronary calcium scan, is now part of Cedars-Sinai Medical Center's arsenal in the war on heart disease. This high-tech weapon, made by Imatron, Inc., is a C-150 Ultrafast CT Scanner. Also known as an Electron Beam CT or EBCT, this highly advanced CT scanner has no moving parts, uses an electron gun with a sweeping beam, and is able to detect very small amounts of calcium in artery walls.
"What this means," says Daniel Berman, M.D., Chief of Cardiac Imaging in the Department of Imaging at Cedars-Sinai Medical Center and Director of the Heart Watch Program, "is that patients who are at risk for coronary heart disease -- the number one cause of death in both men and women in America -- can now be identified much earlier. And that means that treatment planning, lifestyle changes, and other interventions can begin much earlier -- when they are most effective."
"Fifty percent of people with heart disease do not know they have problems until they experience an event with irreversible damage or even death," says Dr. Berman. "While we have recently seen multiple major breakthroughs in the medical treatment of coronary artery disease, the key to effective treatment is early identification of patients at-risk, before they experience a damaging episode, so as to begin a specific treatment plan most appropriate for them." The Heart Watch Coronary Calcium Scan provides the earliest definite detection of coronary artery disease."
When standard methods of detecting coronary artery disease are used, the disease process has to be severe enough to impede blood flow before it can be identified. "In contrast," says Dr. Berman "the Heart Watch Coronary Calcium Scan identifies small amounts of calcium in vessel walls (calcium is what is responsible for the 'hardening' in the process of hardening of the arteries or arteriosclerosis). The EBCT scanner can detect calcium deposits long before they are large enough to form an obstruction in a coronary artery. This, in turn, enables physicians to implement specific treatment plans much earlier than in the past."
Just as important, the technology enables physicians to follow patients over time, tracking the progress of the disease (or hopefully its lack of progression) under treatment, and facilitating appropriate change in treatment for patients in whom the disease process appears to worsen.
In fact, a comprehensive cardiac assessment is provided for Cedars-Sinai patients who have a Heart Watch Coronary Calcium Scan. This assessment includes the Coronary Calcium Scan, cardiac history, cholesterol panel, blood pressure and vital signs, all integrated into a personalized cardiac risk report for the patient.
According to P.K. Shah, M.D., Director of Cardiology at Cedars-Sinai, the arrival of the Heart Watch Coronary Calcium Scan offers a unique opportunity for collaboration between the Imaging and Cardiology departments, with unprecedented clinical, research and preventive applications. Although the scanner will be also be used for non-cardiac imaging, its primary purpose at Cedars-Sinai will be to identify, non-invasively, plaque build-up in the coronary arteries of patients, thereby enabling physicians to better predict the risk of future heart attacks and institute preventive measures.
"We in Cardiology are quite excited about the Heart Watch Coronary Calcium Scan," says Dr. Shah. "It will enable us to non-invasively identify plaque build-up in the coronary arteries, offering opportunity for improved patient care while at the same time enabling us to conduct important research in the area of coronary artery disease." Some of this research will be supported by the Steven S. Cohen Heart Foundation, a foundation formed by the friends and family of the late Steven S. Cohen after undetected coronary heart disease resulted in sudden cardiac death when he was only 35.
Although the noninvasive technique is promising for early detection of coronary artery disease, more research is necessary to fully define the ultimate role of this new technology and its impact on patient outcome. The Department of Imaging and the Cardiology Division are collaborating in a research program on subjects undergoing the Heart Watch Coronary Calcium Scan which will include a battery of sophisticated blood tests to determine their added value for predicting the risk of future heart attacks. "While it is unlikely that the Heart Watch Coronary Calcium Scan will replace existing techniques, it will most certainly complement them," says Dr. Shah.
Similar in concept to a conventional CT scanner, the EBCT scanner offers clearer imaging of the heart. Conventional scanners need time to rotate mechanically around the patient, resulting in blurring of cardiac images due to heart motion. In contrast, with the Ultrafast EBCT scanner, only an electron beam sweeps around the patient, so those three-dimensional images can be taken in 1/20 of a second -- 20 times faster than conventional CT scanners. This extremely high-speed beam results in 'stop-action' three-dimensional images with unparalleled clarity.
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