Studies highlight strength of ultrasound as a heart disease tool

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Several studies presented at the 18th Annual Scientific Sessions of the American Society of Echocardiography (ASE) in Seattle, June 16-20, reinforce the understanding of ultrasound as an important tool in combating various forms of heart disease.

One study showed that stress echocardiography, a heart ultrasound performed during stress testing, is a more accurate method for identifying women at highest risk for coronary artery disease (CAD) than traditional stress testing and clinical risk factors.

"Our study shows that stress echocardiography can stratify women at the highest risk of coronary artery disease into those that are at risk of having a heart attack or cardiac death. This allows women to receive more focused and appropriate treatment that is customized to their specific risk level and outcomes," said Farooq A. Chaudhry, MD, director of echocardiography, associate chief of cardiology, St. Lukes-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons.

Another study conducted at the University of Nebraska Medical Center in Omaha, Neb., found that real-time perfusion echocardiography is helpful in identifying diabetics without symptoms who are at risk for coronary artery disease.

Traditional heart ultrasound continues as the best test for identifying many different abnormalities in the heart, yet the ability to assess the blood flow within the heart muscle by using a contrast agent, in addition to defining abnormalities, would be a major breakthrough for diagnosis and treatment of heart diseases, the researchers found.

A third study looked at contrast echocardiography when used to separate patients presenting with low-risk and non-life threatening chest pain from those who may be experiencing a heart attack. This research shows that myocardial contrast echocardiography (MCE) may more accurately diagnose life threatening heart disease, decrease unnecessary hospital admissions and reduce patient cost.

The ultrasound contrast agents used in this study are currently being used to improve ultrasound image quality. FDA approval is pending for the use of these contrast agents to evaluate blood flow in the heart muscle.

The results showed that by using MCE to evaluate patients presenting with suspected heart chest pain, 55 percent of the patients studied could have been discharged from the emergency department.

A fourth study found that screening vascular ultrasound (SVU) is effective in identifying patients with cardiovascular disease before they show symptoms and become ill.

Dr. John Postley of Columbia University in New York, N.Y., evaluated 398 patients, ages 33-79, using both Framingham Risk Score (FRS) and SVU. Of the 398 patients, SVU found 171 patients to have plaque build-up in the arteries of the neck and thigh. Of those 171 who were found to actually have plaque build-up, 25 percent of men and 35 percent of women were categorized as low risk by FRS.

"These findings suggest that even patients with low Framingham Risk Scores may have cardiovascular disease, as demonstrated by the presence of plaque build-up, and that screening vascular ultrasound is an effective method to identify these patients," said Postley. "This combination of technologies is wonderful news for the medical community as it will help identify people with clogged arteries before they even begin showing symptoms, allowing physicians to be more proactive in treatment."