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Coronary Atherosclerosis Imaging

Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosc...

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Detalles Bibliográficos
Autores principales: Henein, Michael Y., Vancheri, Sergio, Bajraktari, Gani, Vancheri, Federico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168918/
https://www.ncbi.nlm.nih.gov/pubmed/31991633
http://dx.doi.org/10.3390/diagnostics10020065
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author Henein, Michael Y.
Vancheri, Sergio
Bajraktari, Gani
Vancheri, Federico
author_facet Henein, Michael Y.
Vancheri, Sergio
Bajraktari, Gani
Vancheri, Federico
author_sort Henein, Michael Y.
collection PubMed
description Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of disease. Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques. Most acute coronary events are triggered by plaque rupture or erosion. Hence, atherosclerotic plaque imaging has generally focused on the detection of vulnerable plaque prone to rupture. However, atherosclerosis is a dynamic process and the plaque morphology and composition may change over time. Most vulnerable plaques undergo progressive transformation from high-risk to more stable and heavily calcified lesions, while others undergo subclinical rupture and healing. Although extensive plaque calcification is often associated with stable atherosclerosis, the extent of coronary artery calcification strongly correlates with the degree of atherosclerosis and with the rate of future cardiac events. Inflammation has a central role in atherogenesis, from plaque formation to rupture, hence in the development of acute coronary events. Morphologic plaque assessment, both invasive and non-invasive, gives limited information as to the current activity of the atherosclerotic disease. The addition of nuclear imaging, based on radioactive tracers targeted to the inflammatory components of the plaques, provides a highly sensitive assessment of coronary disease activity, thus distinguishing those patients who have stable disease from those with active plaque inflammation.
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spelling pubmed-71689182020-04-20 Coronary Atherosclerosis Imaging Henein, Michael Y. Vancheri, Sergio Bajraktari, Gani Vancheri, Federico Diagnostics (Basel) Review Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of disease. Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques. Most acute coronary events are triggered by plaque rupture or erosion. Hence, atherosclerotic plaque imaging has generally focused on the detection of vulnerable plaque prone to rupture. However, atherosclerosis is a dynamic process and the plaque morphology and composition may change over time. Most vulnerable plaques undergo progressive transformation from high-risk to more stable and heavily calcified lesions, while others undergo subclinical rupture and healing. Although extensive plaque calcification is often associated with stable atherosclerosis, the extent of coronary artery calcification strongly correlates with the degree of atherosclerosis and with the rate of future cardiac events. Inflammation has a central role in atherogenesis, from plaque formation to rupture, hence in the development of acute coronary events. Morphologic plaque assessment, both invasive and non-invasive, gives limited information as to the current activity of the atherosclerotic disease. The addition of nuclear imaging, based on radioactive tracers targeted to the inflammatory components of the plaques, provides a highly sensitive assessment of coronary disease activity, thus distinguishing those patients who have stable disease from those with active plaque inflammation. MDPI 2020-01-24 /pmc/articles/PMC7168918/ /pubmed/31991633 http://dx.doi.org/10.3390/diagnostics10020065 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Henein, Michael Y.
Vancheri, Sergio
Bajraktari, Gani
Vancheri, Federico
Coronary Atherosclerosis Imaging
title Coronary Atherosclerosis Imaging
title_full Coronary Atherosclerosis Imaging
title_fullStr Coronary Atherosclerosis Imaging
title_full_unstemmed Coronary Atherosclerosis Imaging
title_short Coronary Atherosclerosis Imaging
title_sort coronary atherosclerosis imaging
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168918/
https://www.ncbi.nlm.nih.gov/pubmed/31991633
http://dx.doi.org/10.3390/diagnostics10020065
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