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Rumberg1

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Rumberg1

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

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