New process spots early heart disease

The ability to detect heart disease in its early stages has just improved, thanks to an advance in diagnostic technology that alerts physicians to the process of atherosclerotic disease, not merely its product. As a bonus, it does so without needles, drugs, exercise, or X-ray dyes. The new procedure, electron beam tomography, works by imaging calcium, a precursor to plaque, in coronary arteries.

"If we know who has the disease, we can offer very effective treatment," says Randolph E. Patterson, director of cardiovascular imaging for the Emory Heart Center and medical director of Lifetech Cardiac Imaging Center, the only facility in Georgia with the revolutionary system. "The problem has been that we don't know who has coronary atherosclerosis until the person has a heart attack, dies suddenly, or develops symptoms."

By detecting the atherosclerotic disease process itself, electron beam tomography enables physicians to diagnose the disease earlier than conventional noninvasive cardiac tests such as computed tomography. Those tests are not conducted until the disease progresses enough to narrow the openings in the artery by at least 50 percent, a dangerous condition that limits blood flow through the artery. And early detection improves the chances of successful treatment.

"If a person has coronary atherosclerosis, the American Heart Association recommends more intensive efforts to lower cholesterol levels and decrease other risk factors," Patterson says. "For example, a physician would be more likely to recommend drug treatment to lower cholesterol if the patient were known to have heart disease. Also, patients who know they have the disease are more highly motivated to change their lifestyle through improving diet, exercising, and quitting smoking."

Minorities report differences in care

As American society grows more diverse, minority groups increasingly report differences in the way they are being treated within the health care system, according to Carol J. Rowland Hogue, director of the Women and Children's Center of the Rollins School of Public Health. Hogue was co-principal investigator of the National Comparative Survey of Minority Care.

In that survey, nearly thirty-eight hundred American adults were questioned about the quality of health care services they had received in the preceding twelve months. The group included white non-Hispanics, African-Americans, Hispanics, and Asian-Americans, including those of Chinese, Korean, and Vietnamese lineage.

Among the findings:

Pinpointing the perils of pollution

The link between excessive levels of lead in children and resulting cognitive deficits is well known. But how do other environmental pollutants affect us-adults and children alike?

That is one question Barry Ryan, a professor at the Rollins School of Public Health, is attempting to answer in a collaborative study sponsored by the Environmental Protection Agency and involving researchers from Emory, Harvard, Rutgers, and Johns Hopkins universities; the University of Arizona; and several private research laboratories.

"We are quite familiar with what comes out of smokestacks or what might be dumped into hazardous waste sites," Ryan says. "This project is addressing a missing link in our understanding of the effect of pollutants on populations-in other words, exactly what we are exposed to in our daily lives."

Ryan studied sixty volunteers over a year to determine their exposure to fifteen different pollutants, including heavy metals. Among other things, he sampled indoor and outdoor air, house dust, drinking water, and soil. He asked questions about diet, daily activities, work, hobbies, housing conditions, and prescription drug use.

Analysis of the data will continue for several years.

­compiled by Andrew Beierle

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