Episode Details

In late 2024 a CT scan revealed a small amount of soft plaque in my arteries. Sixteen months later I scanned again, and my plaque volume had dropped by around forty percent. In this episode I ask the cardiologist behind the technology whether a result like that can really be trusted.

Dr Campbell Rogers is an interventional cardiologist, a former Harvard faculty member who ran the cath lab at Brigham and Women's Hospital, and now Chief Medical Officer at Heartflow.

What we cover:

• The difference between a calcium score, a CT coronary angiogram, and AI plaque analysis
• Why a calcium score of zero does not mean you are free of disease
• What my own scans showed, and why Campbell believes the result
• Soft versus calcified plaque, and why calcification can be a sign of stabilisation
• Treating the plaque you can see rather than just an ApoB number
• Who should consider getting scanned, and the honest trade-offs

This is a conversation about seeing a disease we used to only guess at, held with the right amount of scientific humility. If you want to understand your own heart health, I think it is well worth your time.

If you enjoy the show, please take a moment to rate and review The Proof on Apple Podcasts or Spotify. It genuinely helps more people find these conversations.

To connect with Dr Campbell Rogers, visit Heartflow.

• How Campbell Rogers went from cardiologist to Heartflow (00:00)
• What Heartflow is and how it works (07:26)
• Coronary CT angiogram vs. stress test (11:54)
• Why symptoms alone miss early heart disease (13:18)
• How Heartflow analyzes CT scans in 90 minutes (15:58)
• Calcified vs. non-calcified plaque: which is riskier (21:28)
• Why calcium score zero doesn't mean no heart disease (28:45)
• Who should get a CT angiogram with AI plaque analysis (31:09)
• Why seeing your plaque improves medication adherence (34:04)
• Simon's 2024 Heartflow scan results (39:12)
• How plaque rupture triggers a heart attack (43:25)
• Simon's 2026 Heartflow scan: 40% plaque reduction in 16 months (45:43)
• How long to wait between CT scans (51:14)
• Heartflow vs. Cleerly vs. QAngio (53:12)
• How Heartflow results led Simon to start statins (58:21)
• JAMA study: Heartflow tracks plaque in prostate cancer patients (1:00:10)
• What is low attenuation plaque and why it's high risk (1:02:53)
• Who should ask their doctor about a coronary CT angiogram (1:07:37)

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