Coronary wall thickness, as measured by MRI, is a promising tool for early detection of coronary artery disease
The thickness of the coronary artery wall as measured is an independent marker for heart disease in women. This is according to a study published in the journal Radiology: Cardiothoracic Imaging. The thickness can be measured by an MRI.
The commonly used Framingham Risk Score has been found to underestimate the chance of heart attacks and other cardiovascular events in asymptomatic women. The score provides estimates of cardiovascular disease risk based on age, sex and other factors.
Imaging tools like coronary computed tomography angiography (CCTA) tend to be used in patients with symptoms or more advanced cardiovascular disease. However they are not recommended for liberal use in risk assessment among the general population with no cardiac symptoms.
Researchers developed and refined an MRI technique that adjusts for the motions of breathing and the beating heart to directly visualize coronary wall thickness
Cardiac MRI has recently emerged as a promising tool for early detection of coronary artery disease. MRI can detect thickening in the walls of the arteries, a change that occurs earlier in the course of heart disease than stenosis, or narrowing of the arteries.
“Despite the significant advances in CCTA technology, it is not appropriate to send all asymptomatic people to CCTA because of the exposure to radiation and chemical dyes used for imaging,” said study lead author Khaled Z. Abd-Elmoniem, Ph.D., M.H.S., from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). “MRI might be a safe alternative in the diagnosis of coronary artery disease without exposing patients to a procedure that carries some risk. The advantage of MRI in this situation is that it can tell us that there is a thickening before stenosis, which is difficult to do with CCTA.”
Researchers developed and refined an MRI technique that adjusts for the motions of breathing and the beating heart to directly visualize coronary wall thickness. The technique was used to assess coronary artery disease in 62 women and 62 men with low to intermediate risks based on their Framingham scores. The patients also underwent CCTA to investigate the association between vessel wall thickness and CCTA-based coronary artery disease scores.
The results showed stark differences between the two groups.
“When we separated the patients into men and women, coronary artery disease in men was, as expected, associated with aging and a high Framingham score,” said Dr. Abd-Elmoniem. “However, in women, both age and the Framingham score were not factors. Vessel wall thickness, as measured by MRI, was the strongest variable associated with coronary artery disease.”
The results point to a potential future role for vessel wall thickness measurements in identifying opportunities for early lifestyle changes or treatment in a young, asymptomatic population. Unlike CCTA, cardiac MRI does not require radiation or contrast dyes. MRI can also be repeated and therefore, it can be useful in monitoring the effectiveness of any therapy, added the researchers.
