Nature Medicine | Spoonful of Medicine

Heart disease test goes green

ICG.jpgHeart disease is the leading cause of death in the United States, and costs the country upwards of $316 billion in terms of healthcare costs, drugs and lost productivity. Yet the methods currently used to identify those at highest risk of heart attack leave much to be desired. A team of researchers hopes to change that by introducing a new type of catheterization procedure that produces detailed images of the fatty buildup inside blood vessel walls in the heart.

“This may be a new way to identify high risk plaques in coronary arteries— the ones responsible for heart attacks,” says Farouc Jaffer of Massachusetts General Hospital in Boston, lead author of a paper describing the technology that appears in Science Translational Medicine today.

The approach uses an imaging agent known as near-infrared lipid-binding dye indocyanine green (ICG)—which is already approved by the US Food and Drug Administration (FDA)—to detect the fatty buildups likely to burst in the heart.

In this proof of principle study, the team fed one group of rabbits cholesterol-heavy foods for eight weeks, while keeping their control counterparts on a healthy diet. They then injected the dye, and 20 minutes later inserted a catheter, which as expected picked up more infrared signals in the rabbits on the cholesterol-rich diet.

In future, the Massachusetts General Hospital team plans to test this procedure in heart disease patients to determine its ability to identify those at highest risk of heart attack.

Image: Aorta after injection of ICG in an atherosclerotic rabbit. Courtesy of Science Translational Medicine/AAAS

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