WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center’s expertise using computed tomography (CT) scans to image heart vessels played a significant role in a Women’s Health Initiative study on hormone therapy published this week in the New England Journal of Medicine.
Wake Forest Baptist developed one of the first cardiac CT systems in the United States and was selected to analyze the results of the study, which involved more than 1,000 women.
The study, known as the Women’s Health Initiative Coronary Artery Calcium Study (WHI-CAC), used CT technology to measure calcified plaque in participants’ heart vessels. The presence of plaque documents the very early stages of atherosclerosis, the buildup of fatty deposits that block arteries and can cause heart attacks and strokes.
Cardiac CT exams to measure calcified plaque require no medications or injections. The study used the technology to determine how estrogen affects the heart vessels of women who begin the therapy in their 50s. Earlier WHI research had shown that when the therapy is started in the 60s, it increases the risk of heart attacks and strokes.
Monkey research conducted at Wake Forest Baptist by Thomas S. Clarkson, D.V.M., Jay Kaplan, Ph.D., and colleagues found that the timing of hormone therapy may make a significant difference. Their findings, combined with data from other researchers around the country, led scientists to conduct the WHI-CACS study. It confirmed the results from the monkey studies – that the timing of hormone therapy makes a difference in how the heart’s arteries are affected.
“WHI-CAS is a good example of a team of researchers using cutting edge technology to perform a clinical trial to provide new insight on an important problem – the effect of estrogen on coronary artery disease,” said Jeffrey Carr, M.D., who developed the cardiac CT technology and directed the cardiac imaging in the WHI study. Carr is a professor of diagnostic radiology.
For the study, cardiac CT exams were performed on more than 1,000 women at 33 facilities across the country. A central imaging analysis laboratory, located at Wake Forest Baptist, coordinated the imaging activities. Because of Wake Forest’s previous experience conducting large research studies, the analysis was completed in record time.
In addition to analyzing the results, Wake Forest Baptist developed a standard procedure and a computer-based training program for technicians conducting the scans, as well as a computer program to almost instantly analyze the results.
Prior to the development of cardiac CT scans, the heart’s vessels were imaged with specialized Electron Bean CT systems that are available at only a few centers in the country. The current cardiac CT systems are based on the prototype CT scanner developed at Wake Forest Baptist.
Carr was involved in standardizing the measurement of coronary artery plaque and was a co-author on the American Heart Association Scientific Statement on coronary artery disease and cardiac imaging.
Wake Forest Baptist is currently using the technology to explore the genetic causes of heart disease, diabetes and obesity.
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Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. The system comprises 1,154 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report.