The Proof with Simon Hill
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Can You Reverse Heart Disease? What My Plaque Scans Showed | Dr Campbell Rogers

July 6, 2026

AI Summary

5 min read

When Dr. Campbell Rogers ran the cardiac catheterization lab at Harvard, he saw the same pattern over and over: two-thirds of patients who underwent an invasive procedure to check for coronary disease walked away with good news—they didn’t need a stent or bypass. The problem was they had to endure an invasive, expensive, and risky test to get that answer. That inefficiency helped drive a shift in cardiology that is now accelerating: moving from treating risk-factor numbers on a chart to directly imaging the arteries themselves. Rogers, now chief medical officer at HeartFlow, joined Simon Hill to explain how AI-powered analysis of routine CT scans can measure plaque volume and composition with unprecedented precision—and what that means for patients trying to understand their real heart health.

From Treating Risk Factors to Seeing Disease

For decades, cardiology has focused on managing the numbers that predict heart disease—cholesterol, blood pressure, risk scores. But those are population-level estimates. Two people with identical lab values can have wildly different amounts of plaque in their arteries. Rogers argues the field is now entering an era where we can stop guessing and start looking directly at the disease.

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What you'll learn

  • 1 (01:03) **Why Look Directly at the Arteries** - The shift from treating risk factors to imaging the disease itself
  • 2 (02:18) **How a Cardiologist Gets Drawn to Coronary Disease** - Dr. Rogers’ path from medical school to running the cath lab at Brigham and Women’s
  • 3 (05:37) **The Invasive Diagnosis Problem** - Why two-thirds of patients who undergo an invasive angiogram end up not needing treatment
  • 4 (07:31) **What HeartFlow Does: From Blood Flow to Plaque** - The evolution of HeartFlow’s technology from FFR analysis to AI-driven plaque quantification
  • 5 (15:28) **Three Buckets of Cardiac Imaging** - Calcium score vs. coronary CT angiogram vs. HeartFlow’s AI plaque analysis
  • 6 (19:00) **Why Quantifying Plaque Matters** - The revolutionary nature of moving from guesswork to direct measurement
  • 7 (23:03) **Plaque Volume, Percentiles, and Age** - How to interpret plaque burden in the context of a patient’s age and sex

+ Full timestamped outline available in the app

Guests on this episode

Simon Hill

Show Notes

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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