A new technology to transform cardiac risk management by imaging coronary artery inflammation

心血管疾病(CVD)正在全球范围内增加，这在很大程度上是由于肥胖和糖尿病的全球流行所致。仅在英国，心血管疾病就影响了700万人，医疗费用高达90亿英镑，经济负担高达190亿英镑。在心血管疾病中，动脉壁上形成的“斑块”可以逐渐变窄，也可以突然破裂，导致突然堵塞，导致心脏病发作或死亡。斑块的形成和心脏病发作的突然发生都是由动脉壁炎症引起的，炎症是认识、发现和治疗心血管疾病的关键因素。然而，在用于常规心血管诊断的大量扫描中，目前没有一种能够识别动脉壁的炎症。诊断技术中的这一重大“缺口”给患者提供了不准确的建议，测试和药物治疗的效率低下和浪费，未能充分利用强大的新药，而这些新药不能“针对”最需要的患者。我们最近发现，动脉周围的脂肪组织“感觉”到了炎症的存在，这可以通过一种新的分析技术来检测，该技术可以应用于现有的心脏CT血管成像(CTTA)扫描，该扫描已经在常规临床使用。这种方法识别出心脏病发作和心血管疾病死亡的高危人群，超过了目前的诊断测试。这项研究工作已经在领先的科学期刊上发表，并引起了国际媒体的兴趣。我们现在正在努力将这项强大的新技术开发成经过仔细测试的商业产品，以改善患者、医生和制药业对心血管疾病的诊断和治疗。我们将通过Caristo Diagnostics实现这一目标，这是我们从牛津大学剥离出来的新公司，与伦敦、莱斯特和牛津的3家合作医院合作。首先，我们将改进新成像技术的技术方面，以确保医院使用的不同类型的CT扫描仪的性能和一致性都是优秀的。接下来，我们将开发一项基于网络的自动化服务，获得所有必要的监管批准，以快速可靠地分析心脏CT扫描。最后，我们将进行一项临床试验，让接受CCTA扫描的CVD患者参与，以展示临床效果和检测药物治疗的效果。Caristo的新成像技术将改变我们目前诊断CVD的方式，指导个性化治疗策略的部署。“

"Cardiovascular diseases (CVD) are increasing world-wide, due in large part to the global epidemics of obesity and diabetes. CVD affects 7 million people in the UK alone, with healthcare costs of £9bn and an economic burden of £19bn.In CVD, formation of 'plaques' in the artery wall can either narrow progressively or can break open suddenly, causing an abrupt blockage that results in a heart attack or death. The formation of plaques and the sudden occurrence of heart attacks are both caused by inflammation in the wall of the artery, which is a critical factor in understanding, detecting and treating CVD. However, none of the enormous number of scans used for routine CVD diagnosis can currently identify inflammation in the artery wall. This major 'gap' in diagnostic technology gives inaccurate advice to patients, is inefficient and wasteful of tests and drug treatments, and fails to take full advantage of powerful new drugs, that cannot be 'targeted' to the patients who need them most.We have recently discovered that the fat tissue surrounding the artery 'senses' the presence of inflammation, and this can be detected by a new analysis technique that can be applied to existing cardiac computed tomography angiography (CTTA) scans that are already in routine clinical use. This method identifies people at high risk of heart attack and CVD death, above and beyond current diagnostic tests. The research work has already been published in leading scientific journals, and generated international media interest.We are now working to develop this powerful new technology into a carefully tested, commercial product, to improve the diagnosis and treatment of CVD, for patients, doctors and the pharmaceutical industry. We will achieve this through Caristo Diagnostics, our new spin-out company from the University of Oxford, working with 3 collaborating hospitals in London, Leicester and Oxford. First, we will refine the technical aspects of the new imaging technology to ensure that performance and consistency is excellent across different types of CT scanners used in hospitals. Next, we will develop an automated web-based service, with all of the necessary regulatory approvals, for rapid and reliable analysis of heart CT scans. Finally, we will conduct a clinical trial, involving patients with CVD undergoing CCTA scans, to demonstrate clinical effectiveness and to detect the effects of drug treatments. Caristo's new imaging technology will transform the current ways that we diagnose CVD, guiding the deployment of personalised therapeutic strategies."