CORONARY heart disease is the nation’s biggest killer – and with 48,000 people in South Yorkshire suffering a heart attack in the last year alone, efforts to give patients more accurate diagnoses and treatments are more important than ever.
A team of doctors based at Sheffield’s Northern General Hospital now believe they have taken a huge step forward by developing a new computer system which helps them detect how severely arteries are blocked.
This will enable cardiologists and surgeons to pinpoint exactly where they should place vital bypass grafts or stents, without any further invasive tests.
An initial study with 20 patients had a 97 per cent success rate – and the team hopes to continue the good results with another three-year trial involving 100 people from around the region.
Dr Paul Morris, specialist registrar in cardiology, says the prototype offers a ‘simpler and more reliable’ method of getting results from angiogram procedures, and ensures that ‘people get treated in the right way’.
“When the disease is very mild we’ll prescribe tablets, or when it’s very severe we’ll do surgery as well as tablets,” he said.
“But if a case is in the middle, it’s very tricky to interpret with the human eye, which is where the need to measure blood pressure changes more accurately comes in.”
Dr Morris explained that ‘a number of assessments and investigations’ are currently available if coronary heart disease is suspected.
“With an angiogram, they will often have dye injected into their arteries through a hole in their wrist or groin, and then we take X-rays.
“Angiograms are brilliant, because you can tell very clearly exactly where the blockages are.
“What they can’t do is provide information on the function of that artery. What would be brilliant is if we had a system which did both of those things in a single test.”
He said doctors can measure pressure by placing a special wire inside an artery, but that this is ‘not ideal’.
“It is more expensive, technically it’s more tricky, and only certain centres can do it.
“The new system takes the pictures which we take at an angiogram, and then builds up a virtual coronary artery, based on a patient’s own blood vessel.
“It then computes the blood pressure differences down the artery.”
In the recent project, doctors measured pressures in the conventional way, then used the computer to predict the results. The system predicted the correct pressure in nearly all of the cases. “We tested it on a relatively small sample because as patients obviously have more than one artery, we were able to test it on 35 arteries,” said Dr Morris.
“It was a good result. It allows us to secure funding to go on to the next phase. We need to make it work faster and a bit more simple to use.
“We would like to develop it over the next three to four years. After that, if it’s successful, there’s no reason why we won’t be able to roll it out for use in the NHS.
“We think it has the potential to improve and save the lives of patients, and save the health service valuable resources.”
The team is made of up doctors and researchers from Sheffield Teaching Hospitals and Sheffield University, and led by consultant cardiologist Dr Julian Gunn, who said the prototype was ‘a real breakthrough’.
“The technology will further improve diagnosis and may reduce the need for some patients to have more invasive tests,” said Dr Gunn.
“It will also help doctors decide which arteries need treating, and even which bits of which arteries, and guide therapy.”
During the three-year study, funded with an £800,000 research grant, the team will test the system in patients with more complicated heart disease.
Dr Morris was recently awarded the British Cardiovascular Intervention Society’s Young Investigator of the Year award for his work on this project.
He was the first doctor from Sheffield to win this award, beating off stiff competition from hundreds of researchers across the globe.