A few days ago we heart about some pleasant news in the field of Medicine. This is about a new technique of early infarction prediction. This method analyses the images of axial tomography of the heart and identifies some of the patients at risk of heart attack, even several years before this happens.
The head of the research team is Professor of Cardiovascular Medicine at Oxford University, Charalambos Antoniades, and their work came to public with the publication in the medical journal "The Lancet". According to the Greek Cypriot professor, they have succeeded in developing algorithms that analyse the fat around the coronary arteries as it is imprinted on the axonal coronagraphs. This fat changes when an artery is inflamed, which is a warning sign for a large proportion of the heart attacks.
In the interview that follows, Mr. Antoniadis speaks to LiFO about the new method, the artificial intelligence, the effect of the stress, Brexit, the environment in which he grew and the chance of his return to Greece.
— Tell us why the early diagnosis method that you announced is so important.
Over the last thirty years we have been trying to develop a method that will detect inflammation in the coronary vessels, which give blood to the heart. The reason is that these arteries lead to the development of tightness. To date, there was no such method to indicate which arteries are inflamed. In fact, what we have discovered is that when the inflamed arteries that give blood to the heart receive some signals from the fat around them, the fat feels these messages and changes some of its features. The challenge, however, for us was the development of a corresponding technology that could read all that I mentioned. This is how we can identify which arteries are inflammatory and which are not.
— How did this technique work?
Through artificial intelligence. In essence, we posed a question as to whether we can find some features in the images we get from an axonal coronary. Then we asked which of these perivascular features change, but they cannot be seen by the naked eye. Of course, the results were some complex mathematical forms that confirmed that they could detect these changes around the vessels. We submitted this promising method about a year ago. What was missing was, however, the basic proof of how to predict heart attacks. So we needed to certify that by detecting the inflammation you can simultaneously detect the infarction. A few days ago, we worked with researchers from Germany and the US to publish this study in the Lancet, one of the largest medical journals in the world, demonstrating the algorithms that analyse fat around the coronary arteries, as seen in axial coronaries.
— Did you use a statistical sample for your research?
We took about 4,000 people, who were healthy and had coronary history in the past, and watched them for ten years. We then identified who suffered a heart attack and who died from it. Then we analysed the images with the new method and we managed to identify who would suffer a myocardial infarction but also who would die in the next five years from this disease. It is worth noting that most of the heart attacks are caused by the fat deposits that are inside the arteries and block blood circulation. Tomographies can show doctors if an artery has already been stenosis due to fat deposits. The new method, therefore, warns of the upcoming problem much earlier. It therefore enables us to see if the arteries are inflamed and if a stenosis develops after five years. So everyone can start taking preventive measures to avoid plaque formation.
— How do you see the implementation of this technology in practice?
Oxford University has created a spin-off company, Caristo Diagnostics, which has set up an online platform where anyone can upload their CT scan and get an answer electronically. Before the platform becomes available to the public, it has to be approved by the US FDA and Certification Mark (CE Mark), which is due to take place by the end of 2019.
— Can artificial intelligence help us in other important medical issues?
It has already contributed in many areas, helping the cardiologist to diagnose a disease, doctors generally analysing images, e.g. in the case of cancerous tumours, substituting in many cases even the biopsy. Because there are several features hidden behind the images, which the human eye cannot distinguish, but the computer may can.
— What would you advise someone to watch his heart, since cardiovascular problems remain the world's leading cause of death?
Indeed, together with cancer, they are the two leading causes of death. What I recommend is the Mediterranean diet. Everyone has to keep their weight low, exercise, avoid junk food, quit smoking and, of course, visit his doctor in time to check if there are some risk factors in his body. It is wrong to do the exam after the infarction. Prevention is of utmost importance.
— Before an infarction occurs there are some symptoms?
50% of the heart attacks occur in people who did not have any symptoms at all. The first narrowing of the artery is usually the onset of the heart attack, and if you do not get it, it can even kill you. The reason is that the slabs are insidious, because they are not so tough and they break easily.
— We live at a time when stress and pressure prevail. How easy is it to deal with?
Look, if I knew the way, I'd apply it to myself (laughs). It is true that stress is an essential part of our lives. We often say "fight it", but unfortunately there is no magic formula for it.
— I mention this because in our country there is a rapid increase in cases of atrial fibrillation that are particularly related to stress.
Indeed, among other things, atrial fibrillation is also associated with anxiety. So, by not getting stressed, it is certain that we will be able to save many diseases. The point is that when society is undergoing a financial crisis and the world has many problems, giving advice to fight anxiety is utterly utopian, there are no tools for doing so.
— In what environment did you grow up and what led you to the medical industry?
I was born in 1974 in the occupied Cyprus, specifically in Morfou, during the war. What I remember is that amid riots I left Cyprus as a refugee and went to Athens, where I studied Medicine. I was attracted by science, especially Medicine, because there are so many situations you are called upon to manage, but also a huge unexplored field. I wanted to deal with the solution of the problems basically, so I chose this road.
— How is it for a child to be born amidst war?
I was born on July 27, 1974, seven days after the invasion. What I hold more strongly is that we managed to get out of this test safe. After that I felt I had nothing to fear.
— Do you live permanently in Great Britain? What has changed after the referendum?
Brexit, according to the official view of Oxford University, is nonsense. I believe that if this is to be implemented we will suffer great damage as a country but also in the fields of research and education. Let's wait; however, not sure that Brexit will eventually be applied. Neither does the English Government itself know what will happen.
— Tell me a great challenge for you in the medical field, which you would like to be remembered for.
What I have been trying for years is to prevent or successfully deal with myocardial infarction. These days we took a big step with the early diagnosis. If we find and how to prevent it, we will, of course, have a great medical discovery. However, we have already covered halfway and I think we are at a relatively good level to say that we can change the course of the infarction.
— Would you return to Greece?
It's a question I always make to myself. I cannot rule out anything but, to be honest, given the current circumstances and my professional development, I find it unlikely.
— What do you consider important in life?
The quest for happiness. Obviously for every person it has different content. Others discover it through the family, others through the profession, social recognition, or the combination of all of them. The important thing, however, is to find what you like, to hunt it and to succeed.
Source: lifo