Dr Scott Murray – Is IVUS Plaque ‘Regression’ Just Measurement Noise?

In this episode of The Feldman Protocol, how much does metabolic health shape cardiovascular risk beyond what standard lipid markers can reveal? Dave Feldman sits down with Scott Murray (MD), a UK-based interventional cardiologist, to explore plaque imaging and its limitations, the role of visceral and perivascular fat in heart disease, the lipid energy model and lean mass hyper-responders, cardiac fuel metabolism and heart failure with preserved ejection fraction, and the challenges of conducting and interpreting cardiovascular trials.🔥 This episode is sponsored by us --Own Your Labs 👉 `https://ownyourlabs.com/sp/47` Private blood testing services🩸Over 300 blood tests💰Extremely affordable❤️ We love our customers(Yes, we are literally funding the entire podcast from our own company -- so if you want to show your support, keep getting your private blood testing through our service. Thank you! 🙏)🔗 CONNECT WITH DAVE FELDMAN:Main Channel: `https://youtube.com/@realDaveFeldman`X/Twitter: `https://x.com/realDaveFeldman`Instagram: `https://instagram.com/realDaveFeldman`Website: `https://thefeldmanprotocol.com`⏱ Chapters0:00 – Cold open & Scott's intro14:21 – Scott's cardiology practice17:28 – Invasive vs. CT angiography24:49 – Collaterals & microvascular function34:31 – Glycocalyx & endothelial health40:28 – Perivascular fat & imaging51:14 – Imaging, CAC, and plaque noise1:00:04 – Lipid hypothesis & population context1:07:05 – CT plaque measurement variability1:19:42 – Perivascular inflammation & Caristo scoring1:29:07 – Lipid energy model discussion1:49:43 – LP(a), acute-phase markers & reverse causation2:05:01 – LMHR study timeline & next scans2:22:57 – Heart fuel preference & HFpEF2:39:08 – PCSK9 trials & all-cause mortality2:52:06 – Run-in periods & trial design concerns3:05:00 – Context, guidelines & patient conversations3:17:35 – GLP-1 peptides & obesity biology3:26:28 – Where to find Scott & closing thoughts#FeldmanProtocol #DaveFeldman #ScottMurray #PreventiveCardiology #HeartHealth #LipidHypothesis #LeanMassHyperResponder #CTAngiography #PlaqueImaging #CardiovascularResearch #MetabolicHealth #LipidEnergyModel #HeartFailure #LPa #GLP1 #TrialDesign #Cardiology #LowCarb #BloodWork