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Synthesis of Monocyte-targeting Peptide Amphiphile Micelles for Imaging of Atherosclerosis
Published on: November 17, 2017
Aortic plaque imaging and monitoring atherosclerotic plaque interventions
Yukihiko Momiyama1, Zahi A Fayad
1National Hospital Organization Tokyo Medical Center, Tokyo, Japan. ymomiyamajp@yahoo.co.jp
Insights
Coronary artery disease (CAD) is linked to abdominal aortic plaques, detectable by MRI. Evaluating atherosclerosis in multiple vascular areas, like the aorta, can identify vulnerable patients and track treatment effectiveness.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Vascular Biology
Background:
- Coronary artery disease (CAD) is a generalized vascular process.
- Associations between CAD and thoracic aortic plaques are known, but abdominal aortic plaque links are less studied.
- Magnetic resonance imaging (MRI) enables noninvasive evaluation of atherosclerosis in both thoracic and abdominal aortas.
Purpose of the Study:
- To investigate the association between abdominal aortic plaques and CAD.
- To explore the utility of MRI in evaluating atherosclerosis across multiple vascular beds.
- To assess the relationship between aortic plaque characteristics and cardiovascular events.
Main Methods:
- Utilized magnetic resonance imaging (MRI) for noninvasive assessment of atherosclerotic plaques in the thoracic and abdominal aortas.
- Correlated plaque presence and characteristics with patient risk factors (hypercholesterolemia, smoking) and clinical outcomes (cardiac events, complex coronary lesions).
- Evaluated the potential of MRI to identify vulnerable patients and monitor plaque progression/regression.
Main Results:
- Thoracic and abdominal aortic plaques show distinct associations with risk factors (hypercholesterolemia and smoking, respectively).
- Complex aortic plaques, particularly in the abdominal aorta, are associated with myocardial infarction and complex coronary lesions.
- MRI can evaluate atherosclerosis in multiple vascular beds simultaneously, aiding comprehensive assessment.
- Aortic MRI may help identify patients at higher risk for cardiovascular events and track treatment response.
Conclusions:
- Atherosclerosis is a systemic disease, and evaluating multiple vascular beds, including the abdominal aorta, is crucial for comprehensive risk assessment.
- Aortic MRI is a valuable tool for identifying vulnerable patients by detecting complex aortic plaques linked to coronary instability.
- MRI facilitates serial monitoring of plaque progression and regression, offering insights into treatment efficacy, though regression dynamics may differ between thoracic and abdominal aortas.
Abstract:
The atherosclerotic process that results in coronary artery disease (CAD) is recognized to be a generalized process that may involve the entire vasculature. The association between CAD and atherosclerotic plaques in the thoracic aorta has often been reported using transesophageal echocardiography. An autopsy study showed plaques in the abdominal aorta, but not in the thoracic aorta, to be severe in patients with cardiac events. However, studies evaluating an association between abdominal aortic plaques and CAD are scarce. Recently, magnetic resonance imaging (MRI) has become a useful tool for the noninvasive evaluation of atherosclerotic plaques in both the thoracic and abdominal aortas. Plaques in the thoracic and abdominal aortas were found to be characteristically associated with hypercholesterolemia and smoking, respectively, suggesting different susceptibilities to risk factors. Because patients have various risk factors, it seems to be preferable to evaluate atherosclerosis in multiple vascular beds than in just 1 bed. Magnetic resonance imaging can evaluate atherosclerosis in multiple vascular beds in the same examination session. Complex aortic plaques, especially in the abdominal aorta, were found to be associated with myocardial infarction and complex coronary lesions, suggesting a link between aortic and coronary plaque instability. Aortic MRI may thus be useful for identifying vulnerable patients. Moreover, MRI is a powerful tool to serially evaluate plaque progression and regression. Intensive lipid-lowering therapy can regress aortic plaques, but the susceptibility to lipid lowering and the process of plaque regression may differ between the thoracic and abdominal aortic plaques.
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