Press release
Studies underway on tests that can predict the onset of a heart attack
World specialists are gathering in Milan for the “Milan Cardiology 2014” Conference
Advances in the prevention of cardiovascular diseases
Diagnostic and imaging tests that allow for detecting dysfunctions even in the absence of symptoms
Milan, 13 February 2014 - Atherosclerosis, hypertension and other causes of heart disease, in particular myocardial ischaemia, plus special focus on dysfunctions of the coronary microcirculation and early diagnosis thanks to investigations such as cardiovascular magnetic resonance and the Positron Emission Tomography (PET). These a just a few of the topics that will be addressed at the international “Milan Cardiology 2014” conference which opened today, organised by Paolo Camici, full professor of cardiology and Director of the School of Specialisation in Cardiovascular diseases at the San Raffaele Vita-Salute University, and sponsored by the Fondazione Internazionale Menarini (Menarini International Foundation).
As Prof. Camici explains, "This is a unique opportunity for some of the greatest European and American experts to join forces at the IRCCS San Raffaele Hospital in Milan for an update on clinical and patho-physiological problems in the field of cardiovascular diseases, and in particular, early diagnosis, which is an essential prerequisite for preventing cardiovascular events".
"The close correlation between myocardial ischaemia and obstructive atherosclerosis of the epicardial coronary arteries (the coronary arteries that run around the outer surface of the heart) has been demonstrated without a shadow of a doubt, and the coronary angiography has shown a link between the severity and extent of coronary artery diseases and survival", states Prof. Camici. "In fact, the epicardial arteries are the easiest to explorein vivo, as they are clearly visible in the coronography (the X-ray for viewing these arteries).
It is a far more complex matter to detect alterations in the function or structure of thecoronary microcirculation, that is, the fine network of intramural vessels with a diameter of less than 300 micron millimetres, the functioning of which can however be non-invasively assessed with the PET. Said alterations are present in numerous clinical conditions and these observations have given rise to the concept of “Coronary Microvascular Dysfunction” (CMD). In patients who complain of anginal symptoms but have a normal coronography, these anomalies represent important risk markers and can contribute to the pathogenesis of myocardial ischaemia, thus becoming potential therapeutic targets.
One well-known cause of CMD is the remodelling of the intramural coronary arterioles.The microcirculation does not just consist of a passive network of vessels through which the blood is transported to the myocardium, but it is also the active site of a very complicated control of the flow and the metabolic activity. In some cases the remodelling of the intramural arterioles may be so severe that it seriously compromises the regulation of the myocardial flow and generates ischaemia.
Cardiologists are well aware of the essential role of diagnostic tests in preventing these events. The frontiers of the potential of diagnostic tests (via imaging and otherwise) are constantly being shifted forwards by the ongoing advances in the field of medical technology and clinical research. This is especially true for cardiology where the investigation methods include numerous and diversified technologies that are in constant evolution.
for the early detection of dysfunctions of the coronary microcirculation. PET imaging allows for passing from an essentially morphological-anatomical assessment of a structure to a metabolic-functional type of characterisation: during a disease, alterations to the metabolic setup happen far earlier than anatomical alterations, and the possibility of detecting these changes makes the PET irreplaceable in the functional assessment of a tissue.
and in some cases it is possible to treat microcirculation dysfunctions with pharmaceutical products which, if promptly administered, can help delay or even stop the progression of the disease", concludes Prof. Camici.