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, FACCClinical Professor of Medicine, Ohio State UniversityClinical Professor of Medicine, Ohio State University

Medical Director, OhioHeartMedical Director, OhioHeartColumbus, OhioColumbus, Ohio

The 3rd Vulnerable Plaque Symposium51st Annual ACC, Atlanta GA, 3/16/02

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 beam introduced in 1984] using a scanning electron beamrather 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 cardiaccycle corresponding to the least ballistic coronary motioncycle corresponding to the least ballistic coronary motion

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, the However, the applicationapplication receiving the most receiving 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

Coronary Artery CalcificationCoronary Artery Calcification

““Hardening”Hardening” of the coronary arteries has known for 300 years; but over the past the past 10 years10 years we have we havefound it is:found it is: An ActiveAn Active ( (notnot passive) passive) processprocess Can Can Occur Occur earlyearly in ASO plaque developmentin ASO plaque development An An Intimate part of Intimate part of the fibroproliferative and the fibroproliferative and inflammatory pathophysiology of CAD inflammatory pathophysiology of CAD RegulatedRegulated in a fashion similar to bone in a fashion similar to bone mineralization and repairmineralization and repair

Coronary Artery Calcium Coronary Artery Calcium and Atherosclerotic Plaqueand Atherosclerotic Plaque

Histology X-Ray