3D Matrix Ultrasound Accurately Identifies Cardiovascular Lesions in Healthy Individuals

A new imaging technique for real 3D vascular ultrasound could become a key tool in strategies to prevent cardiovascular disease in apparently healthy people, alongside traditional risk parameters such as cholesterol and high blood pressure . The new results, published in JACC: Cardiovascular Imagingshow that true 3D vascular ultrasound is reliable, accurate, and faster than previous methods for assessing plaque volume in carotid and femoral arteries.

The burden, or amount, of atherosclerosis in the carotid and femoral arteries is a well-established marker of cardiovascular risk and is highlighted as a key parameter in international clinical practice guidelines and expert consensus documents. There is therefore a recognized need for better and easy-to-use methods to measure plaque load that can be used as population screening tools.

The new imaging method was first validated and implemented in a study of nearly 200 healthy participants at intermediate cardiovascular risk of the Athero Brain: Head-to-Heart Study, led by Dr. Valentin Fuster, general manager of the Center National de Investigaciones Cardiovasculares (CNIC). The method has now been incorporated into the PESA-CNIC-SANTANDER study, also led by Dr. Fuster, where it is used to assess over 4000 healthy people over a 9-year follow-up.

The PESA-CNIC-SANTANDER study, started in 2010 and recently extended to 2030, is one of the largest cardiovascular prevention studies in the world.

CNIC researchers have partnered with Philips Ultrasound and Philips Research Paris-Medisys to develop a new probe and software for real 3D ultrasound to facilitate exploration of the carotid and femoral arteries and to speed up the quantification of the volume of the atherosclerotic plaque. As Dr. Fuster explained, “it is clear that traditional clinical assessments based on measurements of cholesterol, blood pressure, blood sugar, and lifestyle habits alone cannot accurately determine the accumulated damage in the cardiovascular system, and without this crucial information, we cannot make appropriate decisions to prevent acute events such as myocardial infarction or stroke.”

The key to personalized prevention and treatment strategies, Dr. Fuster added, “is the ability to detect and quantify an individual’s accumulated cardiovascular damage, or atherosclerotic burden, using non-invasive imaging techniques. invasive”.

The newly validated 3D vascular probe incorporates 3D matrix technology, which underpins the most advanced 3D ultrasound techniques. CNIC’s Director of Clinical Research, Dr. Borja Ibáñez, explained that the new technology allows simultaneous 2D and 3D ultrasound analysis, includes all features (color doppler, power doppler and contrast ultrasound) and is easily integrated in daily clinical practice by technicians and physicians. teams already experienced in ultrasound, emphasizing that “the integrated analysis software integrates true 3D data processing”.

In addition to demonstrating the accuracy of 3D matrix ultrasound, the study demonstrates that the new technique takes only half the time of previous methods to obtain all the information needed to define carotid and femoral plaque load, information essential for good patient care.

For patients, the outstanding feature of the new method is that the software generates a virtual 3D image of their own arteries, allowing them to see accumulated damage. “When patients see the state of their arteries, it makes them realize the need to change their lifestyle, in a graphical way not achieved by reading a list of analytical data,” said first author Dr. Beatriz López Melgar, cardiologist at La Princesa University Hospital and responsible for the 3D cardioprevention program at HM Monteprincipe Hospital to Madrid.

And for healthcare professionals, Dr. López Melgar continued, “the ability to view plaques in 3D allows us to assess them more accurately and in full, which is not possible with conventional 2D methods. 3D ultrasound also provides invaluable information about plaque morphology.”

“Similarly, this technological advance will soon allow us to analyze plaque composition and use this information to assess the burden of ‘junk plaques’ (high lipid plaques that may be at increased risk of rupture and disintegration). (triggering events, such as stroke).The unwanted plaque load is a very promising marker that, until now, could only be assessed using very advanced techniques involving radiation, such as CAT and PET. Today, with 3D array technology, measuring unwanted plaque load is a realistic goal of cardiovascular ultrasound studies.”

For this reason, added Dr. López Melgar, “we believe that the development of ultrasound methods will contribute to the expansion of personalized medicine and the use of diagnostic imaging techniques, and will also help ensure that improvements in patient care produce benefits for a wider sector of the population.”

López Melgar concluded that with the development of this technology, “we now have a tool that can be used on the fly during an initial consultation, speeding up decision-making – an important consideration in cardiovascular prevention, where time is running out petrol.”

Collaborators on this project included scientists from the Spanish Cardiovascular Research Network (CIBERCV), and financial support was provided by the Ministry of Economy, Industry and Competitiveness (MEIC) and the European Regional Development Fund.

About Florence L. Silvia

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