[Vulnerable plaque imaging: is it time for its application in clinical practice?].

Area of Science:

• Cardiovascular Medicine
• Pathophysiology
• Medical Imaging

Background:

• Atherosclerosis is a progressive disease where plaque rupture can cause acute thrombosis and clinical events.
• Plaque instability is influenced by biological and morphological factors, particularly the fibrous cap's integrity.
• Systemic inflammation and coagulation cascade activation contribute to myocardial infarction risk.

Purpose of the Study:

• To identify biological and morphological factors of coronary plaque instability.
• To explore the role of plaque morphology and systemic responses in acute myocardial infarction risk.
• To evaluate advanced intracoronary imaging for defining vulnerable plaques and predicting acute coronary events.

Main Methods:

• Review of recent advances in intracoronary imaging techniques.
• Focus on high-resolution imaging for defining vulnerable plaque characteristics.
• Consideration of optical coherence tomography (OCT) as a promising imaging modality.

Main Results:

• High-resolution imaging can provide critical information on atherosclerosis pathophysiology and myocardial infarction causes.
• Vulnerable plaque characteristics, likely to rupture, can be identified by these new imaging techniques.
• A potential scoring system for atherosclerotic plaque instability could prospectively identify acute coronary events.

Conclusions:

• Advanced imaging techniques are expected to identify key characteristics of vulnerable plaques.
• Combining morphological data with systemic vulnerability markers may predict individual risk for acute myocardial infarction.
• Optical coherence tomography shows promise for assessing plaque vulnerability and preventing acute coronary events.