CT Scans of Ancient Egyptian Princess Shows Coronary Artery Disease

Wheat and barley were grown along the banks of the Nile, making bread and beer the dietary staples of this period of ancient Egypt. Tobacco and trans-fats were unknown, and lifestyle was likely to have been active.

The coronary arteries of Princess Ahmose-Meryet-Amon, as seen by whole body CT scanning, was featured in two presentations at the International Conference of Noninvasive Cardiovascular Imaging (ICNC) in Amsterdam, The Netherlands, May 15-18, 2011. ICNC is now one of the world's key scientific events in nuclear cardiology and cardiac CT imaging.

Both presentations were based on findings from the Horus study, in which arterial atherosclerosis was investigated in 52 ancient Egyptian mummies. Results have shown that recognizable arteries were present in 44 of the mummies, with an identifiable heart present in 16. Arterial calcification (as a marker of atherosclerosis) was evident at a variety of sites in almost half the mummies scanned, prompting the investigators to note that the condition was common in this group of middle aged or older ancient Egyptians; the 20 mummies with definite atherosclerosis were older (mean 45 years) than those with intact vascular tissue but no atherosclerosis (34.5 years).

Although comparatively common at other vascular sites, atherosclerosis in the coronary arteries was evident in only three of the mummies investigated, but was clearly visualized in Princess Ahmose-Meryet-Amon (in whom calcification was present in every vascular bed visualized).

"Today," said Dr. Gregory S. Thomas, director of nuclear cardiology education at the University of California, Irvine (USA), and coprincipal investigator of the Horus study, "she would have needed by-pass surgery. Overall, it was striking how much atherosclerosis we found," said Dr. Thomas. "We think of atherosclerosis as a disease of modern lifestyle, but it's clear that it also existed 3,500 years ago. Our findings certainly call into question the perception of atherosclerosis as a modern disease."

If, however, the princess enjoyed a diet believed to be healthy and pursued a lifestyle probably active, how could this "disease of modern life" affect her so evidently? Dr. Thomas and his coprincipal investigator Dr. Adel Allam of Al Azhar University (Cairo, Egypt) suggest three possibilities.

First, that there is still some unknown risk factor for cardiovascular disease, or at least a missing link in the determination of it. Dr. Allam noted a likely effect of genetic inheritance, pointing out that much of the human predisposition to atherosclerosis could be secondary to their genes. He similarly raised the possibility that an inflammatory response to the frequent parasitic infections common to ancient Egyptians might predispose to coronary disease--in much the same way that immunocompromised HIV cases seem also predisposed to early coronary disease. Nor can a dietary effect be excluded, in spite of what is known of life in ancient Egypt. Princess Ahmose-Meryet-Amon was from a noble family, her father, Seqenenre Tao II, the last pharaoh of the 17th Dynasty. Therefore, it is likely that her diet was not that of the common Egyptian. As a royal, she would have eaten more luxury foods--more meat, butter and cheese. Moreover, foods were preserved in salt, which may also have had an adverse effect.

In spite of the suggestion of a genetic, inflammatory, or unknown effect, Drs. Thomas and Allam were keen not to discount those risk factors for heart disease, which we do know about. Indeed, even in the study's apparent association of atheroma with increasing age, there was a pattern of prevalence consistent with our own epidemiology today. "Recent studies have shown that by not smoking, having a lower blood pressure and a lower cholesterol level, calcification of our arteries is delayed," said coinvestigator Dr. Randall C. Thompson of the St. Luke's Mid-America Heart Institute (Kansas City, USA). "On the other hand, from what we can tell from this study, humans are predisposed to atherosclerosis, so it behooves us to take the proper measures necessary to delay it as long as we can."

Most of the Horus study research was performed at the National Museum of Antiquities in Cairo and would not have been possible without the availability of noninvasive CT scanning, the focus of the ICNC congress in Amsterdam, The Netherlands. CT scanning and nuclear medicine imaging are the foundation of modern quantifiable cardiac disease detection.

Related Links:
University of California, Irvine
Al Azhar University
St. Luke's Mid-America Heart Institute