Optical imaging may be ‘game-changer’ for predicting heart attacks

A new optical-based imaging technique may change the way cardiologists predict future heart attacks.

Massachusetts General Hospital-led researchers developed an improved optical coherence tomography imaging method that can distinguish life-threatening coronary plaques from those that are less dangerous. The findings, shared in JACC: Cardiovascular Imaging, may arm physicians with new information critical to predicting and treating damage in the heart's major blood vessels.

“This research relies on the latest optical imaging techniques to systematically categorize plaques as indicators of coronary artery disease,” Behrouz Shabestari, PhD, director of the National Institute of Biomedical Imaging and Bioengineering program in Optical Imaging and Spectroscopy, said in a statement. “The technique could be a game-changer for cardiologists and their patients, offering refined insight into coronary arterial atherosclerotic lesions with quantifiable imaging data.”

Coronary artery disease is the most common type of heart disease in the U.S., occurring when atherosclerotic plaques accumulate inside the arteries, hardening them and restricting blood flow. Some plaques, however, are more prone to rupture, which can result in blood clots and heart attacks. Other coronary plaques, such as those involved in angina disease, may weaken heart function over time, but do not pose an immediate threat.

To gain a better understanding of the difference, the researchers analyzed the properties of coronary atherosclerotic plaques in 30 participants with coronary artery disease, looking for markers of instability. Twelve cardiac catheterizations—used to measure properties of the coronary artery wall—were performed on patients with a higher risk form of coronary artery disease, while 18 were conducted on patients with more stable symptoms.

After analyzing 342 cross-sectional plaque images and 244 pictures of high-risk and stable plaques, the researchers were able to separate images into seven different categories, ultimately allowing them to determine which were more likely to rupture.

“This is the first-in-human pilot study of intravascular polarimetry,” Brett Bouma, PhD, professor of dermatology and health sciences and technology at MGH, said in the statement, noting that fibrous caps of plaques that are more likely to rupture can now be reliably identified using the method. “Intravascular polarimetry may open new avenues for studying plaque composition and detecting high-risk patients,” Bouma added.