cardiac ultrasound examination testing on young man

Heart Scan Versus IMT: What Is The Best Way To Measure and Monitor Arterial Plaque?

One point that I to often bring up on the Peak Testosterone Forum is that most erectile dysfunction is a result of heart disease and most heart disease is a result of arterial plaque (atherosclerosis). I won’t go into all the scientific evidence for that, but you can read some about it here if you are interested:  Scary Heart Attack Risk If You Have Erectile Dysfunction and Erectile Dysfunction and Arterial Plaque. In the meantime, you’ll have to trust me that it is critical to your sex life that you measure and monitor your arterial plaque levels. (And it will probably help you to avoid a heart attack!)

There are two basic ways that physicians typically measure arterial plaque levels – at least among the doctors that care about it:

a) IMT (CIMT).  This is an ultrasound of the carotid (neck) artery and measures intima media thickness, which is the “donut” part of your artery that includes plaque and is correlated to your atherosclerosis.

b) Heart Scan (Calcium Score). This is a sophisticated 64-slice (usually) count CT scan of the cardiac artery and measure the calcium in your artery, i.e. the calcified part of your plaque.

There are other techniques – more on that below – but, again, these are the ones that are accessible under normal circumstances. Each of these methods (IMT and Heart Scan) has its pros and cons and below is a quick summary. Keep in mind that it is much better if you work with a knowledgeable doctor when it comes to plaque of course. My purpose here is to give you some ground level information so that you can quickly get up to speed and “talk shop” with him or her.

What about working with a cardiologist?  I hate to say it but most cardiologists do not want to spend the time helping you to regress your plaque:  it’s much more lucrative to tell you that you need a stint or a bypass or an angioplasty in a few years, right?  However, there are some excellent cardiologists that love this stuff out there, so you have to really ask around.

PROS OF A HEART SCAN: In his bestselling book Track Your Plaque, Dr. William Davis argues forecfully that a Heart Scan is the best method for measuring plaque in those with heart disease, because it is plaque in the cardiac artery that most often kills us men. It also provides an accurate number that can be tracked easily on an ongoing basis, and there is extensive research dealing with risk levels by age range and so on.

CONS OF A HEART SCAN: A Heart Scan does involve some radiation unfortunately. The device is very sophisticated and times the scan of a “slice” of your heart artery with the beating of your heart to minimize exposure time. I have had trouble finding the exact radiation exposure from this procedure, so discuss with your provider.  Most states will allow you to get a Heart Scan without a doctor’s orders and the cost is typically right around $100, so you will have to do some research regarding the radiation.

A significant disadvantage of a Heart Scan in the minds of many is the fact that it does not measure soft plaque. It turns out that the plaque in your arteries goes through an actual hardening process. It starts out as soft fatty streaks, which then build up and can eventually harden into calcified deposits. Most people have significant soft plaque even if they don’t have any hard plaque yet. Soft plaque can increase the risk of stroke and heart attack, so it is possible to have a perfect Heart Scan and have a heart attack.  However, the studies show that this is unlikely, and a Heart Scan of 0 is very good news indeed.

NOTE:  I was fortunate enough to have a zero Calcium Score a couple of years ago, something I talk about here:   Heart Scan Results. I attribute it to a low fat and largely plant-based diet.  I can never “rest on my laurels” though and continually work on lifestyle and measure my lipids, glucose/insulin and other parameters.

PROS OF AN IMT: An IMT involves no radiation and is ultrasound only. An IMT also monitors both hard and soft plaque. There is a company that I have heard and have no affiliation with (Lifeline) that offers IMT’s without a direct doctor’s orders for $70 the last time I checked.

CONS OF AN IMT: I have read that IMT’s do not have the kind of accuracy to let you monitor changes within a year very well. It is best something done maybe once a year and the trend monitored according to that school of thought. Other doctors feel that an IMT is sufficiently accurate.

NOTE2:  The ultimate technique is probably the PET-CT, which combines the CT of a Heart Scan with PET (Positron Emission Tomography) which shows function of the arteries as well.  Dr. K. Lance Gould, who is one of the two main  Doctors Reversing Arterial Plaque in my opinion, uses this technique.  See this page for more information:  Heal Your Heart by K. Lance Gould, a book on how to regress your arterial plaque.

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