First published in the Herald Sun on 11 October 2017
Lucie van den Berg, Medical reporter
A 30-minute test for coronary artery disease aims to cut the number of invasive investigations patients have to undergo to get their diagnosis confirmed.
The single test, which uses a patient’s CT scan to make a 3D model of the heart arteries and simulate blood flow, is designed to be faster with less ¬potential side effects than current techniques.
MonashHeart interventional cardiology fellow Dr Abdul Rahman Ihdayhid said when a patient was suspected of having clogged arteries, they usually had a CT scan.
While it could highlight narrowings in these small tubes, he said that without further invasive tests, the cardiac CT could not say how blood flow to the heart was ¬affected.
Not all clogged arteries require a stent or bypass surgery and in some cases, medication is sufficient.
“The current gold standard for measuring blood flow is an angiogram,” Dr Ihdayhid said.
“It’s done in the catheter lab where we put a specialised pressure wire down someone’s coronary artery and measure the blood flow.
“It’s an invasive procedure associated with potential side effects, discomfort to the patient and considerable cost to the health system.”
MonashHeart interventional cardiology fellow Dr Adbul Rahman Ihdayhid has developed a 30-minute test for heart disease. Picture: Jake Nowakowski
Blood flow can also be determined using a second CT scan and injecting dye, but this exposes the patient to further radiation.
A new technique, to be trialled on 500 Victorian patients, may prevent some from requiring these tests.
Dr Ihdayhid said CT Derived Coronary Artery Fractional Flow Reserve took the patient’s original CT scan, made a 3D model of the heart and used computer analysis and complex engineering principles to simulate blood flow through the arteries. The technique is already used in the US, however there it requires a super computer and takes days to process.
Developed by Toshiba Medical Japan in collaboration with MonashHeart, the new test can be done in 30 minutes using a standard computer.
Dr Ihdayhid and his Mon¬ash University PhD supervisor, Associate Professor Brian Ko, showed in a small trial that the world-first technique was as accurate at measuring blood flow in an artery as the gold standard invasive test.
“By using a single CT scan to assess the degree of plaque narrowing in addition to the effect it has on blood flow to the heart, we hope to reduce further stress testing and unnecessary angiograms in some patients,” Dr Ihdayhid said.
“In the future, using a 3D model of the patient’s artery we would like to virtually simulate the effects and potential benefit of a stent or bypass graft on blood flow to their heart muscle.”