Not so young at heart: MRI reveals plaques

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  • Published: Nov 1, 2011
  • Author: David Bradley
  • Channels: MRI Spectroscopy
thumbnail image: Not so young at heart: MRI reveals plaques

Risky youth

Atherosclerosis - the potentially lethal accumulation of fatty deposits in the walls of one's arteries - is commonly thought of as a disorder associated with old age. However, an MRI study by the Heart and Stroke Foundation that measured fat distribution more precisely than before reveals that young people are also susceptible to the disorder.

Eric Larose, an interventional cardiologist at the Institut universitaire de cardiologie et de pneumologie de Québec, Canada, suggests that the proportion of young, apparently healthy adults who appear to be "the picture of health" but who already have atherosclerosis is staggering. The disorder is a major risk factor for heart disease, stroke, or even death.

Larose and colleagues enlisted 168 volunteers aged 18 to 35 years, 84 male, 84 female, all with a known family history of premature cardiovascular disease or associated risk factors including diabetes, high blood cholesterol, high blood pressure, or smoking. The team recorded height, weight, body-mass index and waist circumference. They then used magnetic resonance imaging to obtain a profile of various body fat deposits including subcutaneous fat and visceral fat of the abdomen and chest cavities. They also measured the degree of atherosclerosis in the volunteers' carotid arteries, which carry blood from the heart to the brain, using MRI.

What a waist

Surprisingly, the team found that although many of the volunteers had none of the standard risk factors for atherosclerosis, they did have some of the associated factors such as greater waist circumference, high levels of visceral fat covering their internal organs. Visceral fat has long been associated with an increased risk of cardiovascular disease, particularly because it can accumulate out of site whereas the more obvious subcutaneous fat of the "skin pinch test" with callipers is now no longer consider to be as closely associated with risk.

Larose suggests that although obesity is a well-known risk factor for cardiovascular disease we are, he says "dropping the ball on a large proportion of young adults who don't meet traditional measures of obesity such as weight and BMI." Those people with high levels of visceral fat tended to have a greater degree of carotid atherosclerosis, the team found, and this did not correlate with their youth nor their apparent health. As such, revelations of atherosclerosis in such individuals might point to the benefits of a more preventive lifestyle for reducing cardiovascular disease risk. "We were encouraged to find that in this young and apparently healthy population, an easy way to measure risk in the doctor's office is through waist circumference," Larose adds. The work corroborates previous data from autopsies of young Americans killed in war or car accidents that showed four out of every five had premature and subclinical (hidden) atherosclerosis.

Heart disease and stroke are important killers in the developed world and increasingly among the affluent in other parts of the world where calorie-rich, but nutritionally, poor fast food is becoming more readily available. There are obvious interventions for reducing the risk of atherosclerosis and associated health problems, such as eating more healthily, not smoking, reducing alcohol consumption and exercising more. The fact that waist measurement is as good an indicator of the presence of arterial plaques in the carotid arteries as MRI provides a simple but very useful test.

The Larose study was presented at the Canadian Cardiovascular Congress 2011, which is co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

 



The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

Atherosclerosis - the potentially lethal accumulation of fatty deposits in the walls of one's arteries - is commonly thought of as a disorder associated with old age.

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