Progress in any scientific field — including cardiology — happens in two ways. There’s the slow evolution of best practices over time; a constant subtle change. Then there are flashpoints; sudden leaps forward that change the context in which slow evolution occurs.
Both types of progress are being made in cardiology right now. This month’s roundup of articles on cardiology and cardiac imaging captures good examples of each. Read on to learn about new guidelines for cardiac imaging, new uses for patient data, and a breakthrough that could change cardiac medicine as we know it.
In the past few years, there has been a push for using lung cancer CT data to search for other chest diseases. Given the demand for value over volume, it seems sensible to mine as much data out of the scan as possible.
However, three prominent cardiothoracic radiologists recently published recommendations to the contrary, at least for long-term smoking patients. They suggest that these patients are already at elevated risk for heart disease, so determining their coronary artery calcium level from an annual CT study would not influence their recommended treatment.
Doctors from the European Society of Cardiology have developed a new kind of heart valve that can be used to treat rheumatic heart disease. Current transcatheter aortic valve implantation (TAVI) treatment is only recommended for patients with calcific degenerative aortic valve disease, but rheumatic heart disease is far more prevalent in patients in developing countries.
The new valve is self-locating, so it does not require high-resolution cardiac imaging for positioning. It also is non-occlusive, meaning it can be installed without stopping blood circulation through rapid ventricular pacing. The doctors who developed the valve anticipate its implantation can be done in hospitals without cardiac surgery, and for lower cost than conventional TAVI.
Health systems are generating ever-increasing amounts of patient data. A new study shows that this data may have clinical uses far beyond improving individual patient outcomes. Scientists used EHR information from the Northwestern Medicine Enterprise Data Warehouse to examine the discharge process employed at the Bluhm Cardiovascular Institute.
Ordinarily this type of research would involve real-time observation in a time motion study. The new methodology uses data that is already generated through the normal course of care delivery, without the need for extra observation. Using a “big data” approach also means the researchers have a larger data sample to work with.
The human body has an impressive capacity to repair damage to itself. Over time, though, the body sustains more damage than it can repair. In the heart, that damage takes the form of fibrotic cardiac muscle — a replacement for damaged muscle cells that is stiffer than muscle — and can lead to loss of function and eventual death.
Researchers are currently working on strategies to convert fibrotic muscle to healthy heart muscle tissue using strands of microRNA. The researchers say within five to ten years the treatment may be ready to repair human heart tissue.
Through research and technological innovation, in subtle ways and in great strides forward, cardiologists continue to shape the future of the profession. These developments and breakthroughs hold promise for greater efficiency, greater effectiveness, and the potential of better outcomes for patients.
Enterprise imaging is one way health systems can take a great stride into the future. Read Beyond Imaging: Key Components for a Holistic Enterprise Imaging Strategy to learn more.