Technology Transforming Heart Care at Lee Health

Advancement happens when technologies become more accurate, efficient, powerful or capable. That is especially true at Lee Health Cardiology, where new imaging technology is advancing diagnostic testing, and artificial intelligence promises to further improve the quality of patient care.

For example, consider Lee Health’s newest cardiac computed tomography (CCT) equipment, an advanced “dual source” scanner.

The advanced technology behind this complex device provides an even more accurate, noninvasive CCT angiography for diagnosis and clarification of chest pain.

It’s used to provide a diagnostic test for obstructive coronary artery disease (CAD) and to detect early plaque that could lead to blockage, according to Dr. Richard Chazal, the medical director of the Lee Health Heart and Vascular Institute.

(Meet Dr. Chazal here).

“The technology allows our cardiologists and radiologists to obtain higher-quality images faster, more efficiently and with less radiation than older-generation CT scanners,” Dr. Chazal says. “This scanner can evaluate more patients in a more accurate manner due to the speed of the scan acquisition, leading to better care.”

More than three million cases of CAD are diagnosed every year in the U.S. Cardiovascular disease kills nearly 700,000 Americans per year, according to the Centers for Disease Control and Prevention (CDC). It is the leading cause of death in the country and worldwide. (The risk of a woman dying from a heart attack is roughly 10 times higher than her risk of dying from breast cancer.)

CAD is associated with reduced blood flow in the coronary arteries that supply the heart with oxygen, which can lead to symptoms of chest pain and shortness of breath.

The scanner’s speed for heart studies is “game-changing,” adds Dr. Heidi Lewis, Lee Health’s Director of Pediatric Radiology. It can take high-quality images in under a second. For Dr. Lewis, this is particularly important when looking at scans on infants because they move frequently and have high heart rates.

With CT scanners looking at heart arteries, most patients need to take medication to slow the heartbeat to decrease motion blurring. Less so with the high-tech scanner, which uses dual source energy, meaning it scans at twice the normal speed to develop images.

“It just scans so quickly; it literally just freezes the heart in motion,” Dr. Lewis notes in a Health Matters segment. “With this machine, it can subtract out (a contrast agent like) iodine and make that non-contrast image from the other image, so that decreases the dose of the scan because you’re not doing a second scan. You can get the same information.”

Dr. Chazal says the scanner can, in many cases, eliminate the need for cardiac catheterization, an invasive imaging procedure that involves putting a tiny tube (catheter) into a blood vessel of a patient’s arm or groin and then into the coronary arteries. 

“In adults, this type of imaging gives us an anatomic image of the coronary arteries and depicts narrowing of the interior of those arteries due to buildup plaque, but also can show very early abnormalities in the walls of arteries before this could be detected by stress testing or heart catheterization,” Dr. Chazal explains. “The idea is to often avoid catheterization in people with symptoms, and to also to detect very early coronary disease, allowing treatment to prevent future heart attacks.”

Looking ahead with artificial intelligence (AI)

Dr. Chazal says AI assessment offers significant potential in cardiovascular disease monitoring and prevention. He cites the use of AI to assess coronary plaque levels in patients with atherosclerosis.

“We’re already using an AI-based digital care platform with coronary computed tomography angiography (CCTA) imaging to help us precisely identify and actually measure the amount of plaque earlier,” Dr. Chazal says.

Currently, the use of AI for CCTA is limited to studies involving the Lee Health employee health plan and some limited additional use, but the hope is to expand this program in the future. Additionally, the use of AI for other modalities, such as echocardiography (ultrasound heart imaging) and cardiac magnetic resonance imaging, is on the horizon at Lee Health.

Atherosclerosis develops as cholesterol, fat, blood cells and other substances in the blood form plaque. When the plaque builds up, it can narrow arteries, which reduces the supply of oxygen-rich blood to tissues of vital organs in the body. If left untreated, the condition can cause heart attack, stroke, and other cardiovascular diseases.

“We’re using AI assessment to analyze, characterize, and quantify types of plaque to determine if a patient’s condition is improving or getting worse,” Dr. Chazal explains. “This has the potential for guiding long-term therapy based on the actual disease rather than estimates of the likelihood of the problem.

“That type of assessment aside, the overall goal of using AI in cardiovascular medicine is to optimize patient care, improve efficiency and improve clinical outcomes. The message is that Lee Health remains engaged in using emerging technology to try and provide the highest level of care for its patients.”