Shedding Light on Heart Plaque

Reported August 2005

LOS ANGELES (Ivanhoe Broadcast News) -- Plaque build-up in the heart is not a good thing. But not all plaque is created equal. The most dangerous type -- called vulnerable plaque -- can lead to a heart attack. With new technology in the works, doctors may soon be able to tell their patients just what kind of plaque they have and how high risk they really are.

Medically speaking, Margaret Rogers has been around the block. "I've had two open-heart surgeries. I had a pacemaker and several angioplasties," she says. "It's been quite a trip." Her latest procedure opened an artery clogged with plaque. Each year, more than 1 million Americans die when plaque ruptures.

"If an artery to the heart abruptly closes off, that area of the heart muscle undergoes damage and the result is either a heart attack or sudden death," P.K. Shah, M.D., a cardiologist at Cedars-Sinai Medical Center in Los Angeles, tells Ivanhoe.

Finding plaque is not hard, but Cedars-Sinai biomedical engineer Laura Marcu, Ph.D., says it's just as important to find what's in the plaque. She says there is a need of new technology capable of detecting the inflammation.

Dr. Marcu is using fiber-optics to find out what kind of plaque a person has. The technology is called laser-induced fluorescence spectroscopy. When cells are excited by ultraviolet light, they emit a specific colored light of their own, much like a signature. Fat or lipid-filled plaque is more likely to rupture than plaque filled with less harmful collagen. With the ultra-violet light, you can see the difference.

"I think the potential is quite enormous," Dr. Shah says. And for Rogers, this new technology is just one more chance at a longer life.

Doctors say when the more dangerous type of plaque is found, there are steps patients can take to turn that plaque into the less-dangerous type, which can reduce the risk of rupture. Those treatments are currently available and used, but this technology would offer a definitive answer on just who needs those treatments.

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