Harvard Heart Letter

Portable ultrasound reveals early signs of heart disease

A portable ultrasound device that detects plaque buildup in arteries may offer a simple, cost-effective way to detect heart disease before it causes any symptoms. A report in the December 2014 Global Heart journal describes findings from a large-scale test of the technology in India, the United States, and Canada.

The innermost layer of an artery's wall (the intima) provides a smooth surface for blood to flow through. The middle layer (the media) contains muscle and elastic fibers that let the vessel expand and contract with each heartbeat. The thicker the intima and the media, the more likely the artery is choked with cholesterol-filled plaque. Using ultrasound, a doctor can easily measure the intima-media thickness in the arteries of the neck and upper leg.

Trained technicians found plaque in 42% of the study participants from North America. One-third of them would not have qualified for statins or other treatments based on the 2013 heart disease and stroke prevention guidelines, which estimate a person's odds of the disease based on age and other risk factors. An editorial accompanying the study says the findings are "a compelling argument" for using ultrasound screening rather than the current risk-based estimate to guide treatment, though more research is needed.

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