Cardiovascular death is the most common cause of mortality among Type 2
diabetics and claims the lives of millions each year, with many
diabetics experiencing their first “symptom” as a heart attack or sudden
death. Understanding that diabetics are at high risk for Coronary Heart
Disease (CHD) and that many with the disease are asymptomatic, Toshiba
America Medical Systems, Inc., has sponsored Speckle Tracking by Echo, a
faCTor64 substudy using Toshiba’s Wall Motion Tracking
ultrasound technology. faCTor64 is a landmark study with
Intermountain Healthcare to assess asymptomatic diabetics using cardiac
CT angiography (CTA) with the Toshiba Aquilion® 64 CT
multi-detector row system.
“Wall Motion Tracking is a new technique to help us more carefully
analyze heart function, specifically the speed of muscle contraction and
relaxation of multiple regions of the heart”
The Speckle Tracking by Echo substudy uses Toshiba’s Wall Motion
Tracking technology to evaluate an asymptomatic diabetic population for
CHD by detecting if patients have a reduction in myocardial strain.
Strain is the percentage change in muscle as the heart contracts. Any
reduction in strain indicates a strong possibility of CHD, so the
patient is sent to CT for further evaluation. Using Echo to evaluate
patients may help physicians detect disease at its earliest stages,
before symptoms are present, using non-invasive ultrasound and could
avoid patients undergoing invasive, costly procedures such as
intervention in the cath lab.
Wall Motion Tracking works by evaluating one piece or region of the
heart muscle and showing how and where that region is moving in relation
to other regions of the heart muscle. It is a sensitive test that can
show abnormalities and even the slightest change in how a part of the
muscle moves, which can be valuable information but difficult to assess
using other methods.
Dr. J. Brent Muhlestein, FACC, director of cardiovascular research,
Intermountain Medical Center, and professor of medicine, University of
Utah, who is leading the Speckle Tracking by Echo ultrasound substudy
and the faCTor64 study, has found that many of the
asymptomatic diabetic patients have some form of CHD.
“Wall Motion Tracking is a new technique to help us more carefully
analyze heart function, specifically the speed of muscle contraction and
relaxation of multiple regions of the heart,” explained Dr. Muhlestein.
“The goal of this substudy is to determine if the information gleaned
through Wall Motion Tracking can be used as an early predictor of
adverse cardiac events. So far, Wall Motion Tracking shows significant
promise as an inexpensive, noninvasive tool to detect subtle differences
in how regions of the heart muscle are working.”
Intermountain Healthcare hopes to enroll more than 300 patients from its
diabetes registry, one of the largest in the country, in the Speckle
Tracking by Echo substudy. Like faCTor64, the Speckle
Tracking by Echo substudy is an outcomes-based trial where, after
monitoring both patient groups, researchers will determine which group
experienced better outcomes.