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Nutrition, risk factors, prevention, and imaging: The 2018 Mario Verani Lecture
1James B. Herrick Professor, Division of Cardiology, Rush University Medical Center, 1717 W. Congress Parkway, Suite 303 Kellogg, Chicago, IL, 60612, USA. kim_a_williams@rush.edu.
Insights
Dietary interventions are key for preventing heart disease, offering the greatest potential for improving cardiovascular outcomes and reducing risk factors. Advanced cardiac imaging aids in early diagnosis and monitoring treatment effectiveness.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Imaging
Background:
- Heart disease remains a leading cause of death despite advances in treatment.
- Current strategies focus on intervention rather than primary prevention.
- Dietary intervention presents a significant opportunity for cardiovascular disease (CVD) prevention.
Purpose of the Study:
- To highlight the critical role of prevention in cardiology.
- To emphasize dietary intervention as a primary strategy for CVD prevention.
- To explore the utility of cardiac imaging in evaluating preventive strategies.
Main Methods:
- Review of current literature on cardiology and preventive strategies.
- Emphasis on dietary interventions for risk factor modification.
- Discussion of cardiac imaging techniques like nuclear perfusion and coronary computed tomographic angiography (CCTA).
Main Results:
- Dietary interventions can improve or eliminate cardiac risk factors.
- Prevention strategies can reduce myocardial infarction, stroke, and cardiovascular death.
- Cardiac imaging provides intermediate markers for evaluating the success of preventive interventions.
Conclusions:
- Prevention, particularly through dietary changes, is crucial for improving cardiovascular outcomes.
- Cardiac imaging techniques are valuable tools for assessing the efficacy of preventive cardiology research and treatments.
- A shift towards proactive, preventive measures is essential in managing heart disease.
Abstract:
Heart disease has been the leading cause of death in the United States since 1918. Cardiac mortality rates have dramatically decreased in this era of advanced medical and interventional therapies. However, this has been aptly described as "mopping up the floor instead of turning off the faucet." With this recognition, prevention in cardiology is poised to become a central focus. Within prevention, dietary intervention is recognized as the single largest opportunity for improved cardiovascular outcomes, including improvement or elimination of cardiac risk factors, prevention of myocardial infarction, stroke and cardiovascular death, and reduction of plaque burden and myocardial ischemia. Cardiac imaging, particularly nuclear perfusion and coronary computed tomographic angiography, plays a critical role in early diagnosis and serial evaluation of myocardial ischemia and coronary artery disease. These techniques have the potential to help refine research protocols and evaluate their success by providing intermediate markers of improved myocardial blood flow and coronary plaque morphology.
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