Carotid Intima-Media Thickness Test (CIMT)
A Carotid Intima-Media Thickness Test (CIMT) is a simple, non-invasive ultrasound that tests for inflammation and plaque in your arteries. At The Heart Attack and Stroke Prevention Center of Central Ohio, we have the technology to see and measure the thickening of your artery walls and indentify any plaque buildup that may be occurring. This efficient, 20 minute ultrasound of your neck is called a Carotid Intima-Media Thickness Test (CIMT) and can provide peace of mind, allowing patients to know their disease status.
Dr. Goulder Explains CIMT
9p21 and KIF6 Genetic Tests
9p21 and KIF6 are genetic tests that tell us if you have an increased risk for developing arterial disease, beyond that of just the standard risk factors of high blood pressure and high cholesterol. We can also use these test to help design a more precision approach to your care. For example, depending on your KIF6 gene status, we can prescribe the correct statin for you, if a statin drug is necessary for your cholesterol. This is not a one size fits all approach, because depending on your KIF6 gene status, certain statin drugs may help lower your cholesterol, but might not give you the full anti-inflammatory effects that another would provide. This is why we offer advanced genetic testing in Columbus and create personalized treatment plans for your optimal wellness.
APOE Genetic Test
The APOE genetic test is used to help us measure how you metabolize fats. There are three versions of the APOE gene, while the APOE4 gene is the one that can give us trouble. In the American Heart Association approach to treating Cardiovascular Disease, they recommend everyone follow the Mediterranean diet, which is a moderate fat reduction diet (with or without alcohol depending on your preference). However, depending on your APOE4 gene status, that diet might not be the correct fit for you, as it may actually increase your risk to developing atherosclerotic disease. By knowing your APOE gene status, we can develop the most personalized heath care and nutrition plan for you.
The Carotid Intima-Media Thickness Test is:
-
Non-invasive
-
Affordable (only $285!)
-
Radiation free
-
Painless and easy
-
No need to disrobe (we are looking at the arteries in your neck)
-
Approved by The American Heart Association over 20 years ago as safe, reliable, and repeatable.
What will I learn from a CIMT?
A CIMT will provide information for three major attributes - the thickness of the lining of the carotid arteries, the presence of plaque buildup, and the arterial age of the arteries.
Oral Glucose Tolerance Test
Insulin resistance and diabetes are a huge cause of inflammation and a risk factor for cardiovascular disease. This is why we go above and beyond the current standard of care to find all the root causes of your arterial disease risk.
The glucose tolerance test, also known as an oral glucose tolerance test, measures your body's response to sugar (glucose). This test can be used to screen for type 2 diabetes, as well as identifying abnormalities in the way your body handles glucose after a meal - often before your fasting blood glucose level becomes abnormal.
We do these tests because while most will do just a fasting blood sugar to test for diabetes or insulin resistance, or hemoglobin A1c (to look at your blood sugar over the past 3 months), just looking at a fasting blood sugar and HbA1c will probably miss about half the people who are truly insulin resistant. Therefore, we go above and beyond the standard of care to perform a complete glucose tolerance test to be certain of your risk.
Advanced Genetic Testing
We can use genetic analysis to find your individual risk for developing arterial disease, and to develop a more personalized, precision approach to your health care. With a simple, non-invasive, 30 second saliva test, we can learn your exact risk factors for the development of arterial disease and provide you with a personalized treatment plan for cardiovascular wellness.
Advanced Lab Testing
Inflammation can be easily measured with advanced testing that assesses your unique inflammatory state and cardiovascular risk. Monitoring your inflammatory status may allow you to catch the beginning, and even treat advanced stages of inflammation, in an effort to reduce your cardiovascular risk. The Heart Attack and Stroke Prevention Center of Central Ohio offers advanced inflammation testing in Columbus, Ohio, which provides additional and complementary insight into cardiovascular risk beyond standard cholesterol testing alone. This inflammation testing consists of simple blood and urine biomarkers that identify inflammatory risk across a risk spectrum. This additional information allows for targeted treatment to reduce your cardiovascular disease risk for a lifetime of optimal health and wellness.
Inflammation Testing
This group of tests covers a patient’s biomarker profile, which may result from lifestyle concerns (F2-IsoPs, OxLDL) to the development of metabolic or cardiovascular disease (ADMA/SDMA, Microalbumin, hsCRP) and formation of vulnerable plaque and increased risk for an adverse event (Lp-PLA2 Activity, MPO). Click here to learn more about inflammatory biomarkers and their association with atherosclerosis.
F2-Isoprostanes (F2-IsoPs) - Prostaglandin-like compounds used for measuring oxidative stress in the body. Elevated levels may be the result of excessive red meat intake, reduced activity levels, and smoking, and identify risk for atherosclerosis and cancer.
Oxidized LDL (OxLDL) - Formed when the apolipoprotein B subunit on LDL particles becomes oxidized. Elevated levels may be the result of poor lifestyle choices and identify risk of metabolic syndrome.
Asymmetric Dimethylarginine (ADMA) - A metabolite of L-arginine, ADMA can inhibit nitric oxide (NO) production. Elevated levels of ADMA are associated with endothelial dysfunction, insulin resistance, hypertension, and subclinical atherosclerosis.
Microalbumin - the quantification of small amounts of albumin (a serum protein) in the urine, to assess function and integrity of the kidneys. Elevated levels of microalbumin/creatinine are associated with endothelial dysfunction and risk of cardiovascular morbidity and mortality.
High-Sensitivity C-Reactive Protein (hsCRP) - an acute-phase protein released into the blood by the liver during inflammation. Elevated levels are associated with the risk of future adverse cardiovascular events in apparently healthy individuals and individuals with stable coronary artery disease.
Lp-PLA2 - a vascular-specific inflammatory enzyme that increases with the activation of macrophages in atherosclerotic lesions of the artery wall under the collagen cap. Increased Lp-PLA Activity is associated with risk of coronary heart disease (CHD) or a CHD event.
Myeloperoxidase (MPO) - a vascular-specific inflammatory enzyme released by white blood cells into the bloodstream in response to vulnerable plaque, erosions, or fissures in the artery wall. Elevated MPO levels are associated with risk of cardiac events in subgroups otherwise characterized as low risk, and may assist cardiovascular risk prediction when used independently or alongside standard biomarker testing, such as hsCRP.
At The Heart Attack and Stroke Prevention Center of Central Ohio, we offer advanced lipid testing to aid in determining cardiovascular disease risk in patients, alongside a standard lipid panel which is commonly performed at least once a year in most medical practices. While a standard lipid panel provides cholesterol and triglyceride measurements, other measurements that are readily available can address additional risk factors for disease including the number of atherogenic particles, the size of these particles, and the inherent risk of developing cardiovascular disease.
Lipid Testing
Electrocardiogram
An electrocardiogram is a simple, painless test that measures your heart’s electrical activity. It’s also known as an ECG or EKG. Every heartbeat is triggered by an electrical signal that starts at the top of your heart and travels to the bottom. Heart problems often affect the electrical activity of your heart. Taking approximately 10 minutes for the test, Dr. Eric Goulder will review your results and use this information as part of your overall assessment.
Periodontal Health Assessment
Periodontal Disease is an infection of your gums that affects 80% of Americans over the age of 30. These harmful bacteria causes inflammation throughout your body, and severely increases your risk for cardiovascular disease, diabetes, dementia, kidney disease, and autoimmune diseases. Periodontal bacteria invades the walls of your arteries, eventually resulting in a thickening of the artery wall, and if untreated leads to a 3x greater risk of dying from a stroke and a 2x greater risk of dying of a heart attack. Additionally, 50% of unexpected heart attacks and strokes are triggered by this oral bacteria that live in your mouth. With our partners at Complete Health Dentistry of Columbus, we test for and treat chronic asymptomatic inflammation associated with gum infections.
Salivary Diagnostics
With any diagnosis of periodontal disease, it is important to find the root cause and the strains of pathogenic bacteria that are in your mouth. As we know, there are many high-risk oral bacteria that can increase your risk and even cause cardiovascular disease, Alzheimer's disease, diabetes, pregnancy complications, cancer, and other inflammatory diseases. And did you know that 50% of unexpected heart attacks and strokes are triggered by oral bacteria that live in your mouth? Through this objective testing, we can evaluate and develop a personalized treatment plan.
Sleep Apnea Screenings
More than 25 million adults in the United States are believed to have moderate to severe sleep apnea (OSA), which is an inflammatory process that in moderate form (meaning you have an AHI of 15-30 events in an hour) is equivalent to smoking one pack of cigarettes a day on the cardiovascular system. With more than 75% of severe cases being undiagnosed in this country, Dr. Barbara McClatchie and our partners at Complete Health Dentistry of Columbus can screen you and develop a personalized treatment plan if necessary.
Dental Clearance
For elective surgeries, most notably artificial joint replacement surgery, a surgeon may require dental clearance prior to the procedure. This clearance is required due to scientific evidence that high-risk oral bacteria can travel throughout the body, from a bleeding gum, and compromise the healing of your artificial joint. This complication can lead to the failure of the surgery, increased revision costs, and long-term health consequences. We offer above standard of care dental clearance services in Columbus, Ohio and the surrounding areas.
Conebeam Scan (3D head & neck x-ray)
Endodontic disease is an infection of the pulp (root) of your tooth that often results in a periapical abscess. This infection is often caused by tooth decay, periodontal disease, or a cracked tooth. These issues can let bacteria enter the pulp of your tooth (the soft tissue of a tooth containing nerves, blood vessels, and connective tissues). When this builds up at the root tip, it forms a pus-filled pocket called an abscess. At Complete Health Dentistry of Columbus, Dr. Barbara McClatchie utilizes 3D Cone Beam technology, which is 21% more effective on average at finding dental infections than average radiography. These infections can often be asymptomatic, so it is very important we identify if this is an issue, as it can cause a heart attack or stroke.
Here at The Heart Attack and Stroke Prevention Center of Central Ohio, we provide advanced testing that is not traditionally offered by current standard of care medical practices. If you are interested in any of the tests below, please contact us to learn more and schedule an appointment.