Literatus: Heart attacks can now be predicted

Tuesday, January 3, 2012

THE recent wave of science and technology developments in medicine, particularly in Japan, gave rise to a better way of predicting deadly turns in coronary artery disease (CAD).

As of 2006, CAD is the leading cause of death in Taiwan. And the disease results from degenerative stiffening of blood vessels in the body, called atherosclerosis.

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During the later part of the 20th century, Japan came up with a technology that measures the stiffness of arteries using pulse wave velocity (PWV). The basic scientific principles of PWV through the arterial tree dates back to 1808 when Thomas Young started investigating it.

As early as 1998, carotid-femoral PWV (cfPWV), the use of PWV in assessing the level of stiffness in the carotid and femoral arteries, is widely accepted as the gold standard in predicting atherosclerosis in heart arteries. By 1999, it became a well-known predictor of death resulting from cardiovascular events. In the 2000s, it became a marker of vascular damage. Last year, the Tomiyama study in Japan used the technology to establish an atherosclerosis index, called carotid-femoral index (CFI).

The only limit found so far was its inability to assess arteries found in the inguinal area.

So as early as 2002, manufacturers started finding ways to meet this need, and devised a machine that the PWV technology use in assessing arterial stiffness in the brachial artery around ankle area, a variation later named as brachial-ankle PWV (baPWV). The Xu study in 2008 confirmed its predictive strength when it noted that a baPWV of more than 18 meters per second often follows a severe heart attack.

In addition, that same cut-off point is diagnostic for identifying patients with the highest coronary (heart) artery calcification (deposition of calcium), which cause the stiffening of the arteries. This information came much earlier in 2004.

The value of the PWV technology in predicting heart attacks cannot be underestimated.

And patients with CAD will be forewarned against upcoming likelihood of a heart attack. That can save their lives in a way not possible decades or centuries ago.

That’s one though technology that we cannot simply brush off with indifference.

As we age, taking care of our heart gets complicated as our aging cells start losing the vibrancy of youth. That extra care often comes needed in the area of healthy food intake and lifestyle. The unhealthy impulses of youth may have to be put in check with the wisdom of growing age.

Tennessee Williams wrote in his novel, A Streetcar Named Desire (1947): “What is straight? A line can be straight, or a street, but the human heart, oh, no, it’s curved like a road through mountains.”