SHAPE Society

1. EBT Calcium Score:EBT Calcium Score:
A Clue to Invulnerable PlaquesA Clue to Invulnerable Plaques
In Vulnerable PatientsIn Vulnerable Patients
John A. Rumberger, PhD, MD, FACCJohn A. Rumberger, PhD, MD, FACC
Clinical Professor of Medicine, Ohio State UniversityClinical Professor of Medicine, Ohio State University
Medical Director, OhioHeartMedical Director, OhioHeart
Columbus, OhioColumbus, Ohio
The 3rd
Vulnerable Plaque Symposium
51st
Annual ACC, Atlanta GA, 3/16/02

2. Electron Beam TomographyElectron Beam Tomography
[EBT][EBT]
Is a unique and established tomographic scanning methodIs a unique and established tomographic scanning method
[1[1stst
introduced in 1984] using a scanning electron beamintroduced in 1984] using a scanning electron beam
rather than a rotating X-ray source [e.g. helical CT]rather than a rotating X-ray source [e.g. helical CT]
Rapidly images the patient’s heart [50 or 100 msec/image,Rapidly images the patient’s heart [50 or 100 msec/image,
Approximately 10 times faster than helical CT]Approximately 10 times faster than helical CT]
Imaging done synchronized at a phase of the cardiacImaging done synchronized at a phase of the cardiac
cycle corresponding to the least ballistic coronary motioncycle corresponding to the least ballistic coronary motion

3. Electron Beam TomographyElectron Beam Tomography
 Over the past 18 years there have > 600 scientificOver the past 18 years there have > 600 scientific
papers published regarding EBT validation andpapers published regarding EBT validation and
applications for cardiac imagingapplications for cardiac imaging
 However, theHowever, the applicationapplication receiving the mostreceiving the most
““notice” (and controversy) has been its ability tonotice” (and controversy) has been its ability to
determine and quantify Coronary Artery Calciumdetermine and quantify Coronary Artery Calcium

4. Coronary Artery CalcificationCoronary Artery Calcification
““Hardening”Hardening” of the coronary arteries has known
for 300 years; but over the pastthe past 10 years10 years we havewe have
found it is:found it is:
An ActiveAn Active ((notnot passive)passive) processprocess
CanCan OccurOccur earlyearly in ASO plaque developmentin ASO plaque development
AnAn Intimate part ofIntimate part of the fibroproliferative andthe fibroproliferative and
inflammatory pathophysiology of CADinflammatory pathophysiology of CAD
RegulatedRegulated in a fashion similar to bonein a fashion similar to bone
mineralization and repairmineralization and repair

5. Coronary Artery CalciumCoronary Artery Calcium
and Atherosclerotic Plaqueand Atherosclerotic Plaque
Histology X-Ray

6. Coronary Artery CalciumCoronary Artery Calcium
and Atherosclerotic Plaqueand Atherosclerotic Plaque
Histology X-Ray