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Platelets in cardiovascular imaging
Andreas Schuster1, Marcus R Makowski, Christian H P Jansen
1Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, St. Thomas' Hospital, 4th Floor Lambeth Wing, London SE1 7EH, UK. andreas_schuster@gmx.net
Insights
New non-invasive imaging techniques visualize thrombus formation in coronary artery disease. Cardiac magnetic resonance imaging (CMR) offers detailed insights into anatomy, perfusion, and myocardial tissue characteristics, advancing patient care.
Area of Science:
- Cardiovascular imaging
- Thrombosis research
- Medical technology development
Background:
- Coronary artery disease (CAD) remains a significant global health burden, with platelet activation and thrombus formation central to acute events like myocardial infarction and stroke.
- Existing treatments, including revascularization and medical therapies, have limitations in addressing the underlying pathophysiology of thrombus.
- Non-invasive imaging modalities are crucial for understanding and diagnosing thrombus formation in CAD.
Purpose of the Study:
- To review current and emerging non-invasive imaging techniques for visualizing thrombus formation in coronary artery disease.
- To highlight the progression of these techniques from preclinical research to clinical application ('bench to bedside').
- To focus specifically on the advancements and clinical utility of cardiac magnetic resonance imaging (CMR) in this context.
Main Methods:
- Review of existing literature on non-invasive imaging strategies for thrombus detection.
- Categorization of techniques based on imaging principles (e.g., native contrast, targeted contrast agents).
- Assessment of the developmental stage (pre-clinical vs. clinical) of various imaging modalities.
Main Results:
- Several non-invasive imaging techniques are being developed to visualize thrombus components (e.g., fibrin, activated platelets) and native contrast differences.
- Cardiac magnetic resonance imaging (CMR) has significantly evolved, providing high-resolution anatomical, perfusion, and tissue characterization (e.g., myocardial scarring) data.
- The reviewed techniques vary in their stage of development, with some already in clinical use and others still in pre-clinical research.
Conclusions:
- Non-invasive imaging plays a vital role in advancing the understanding and clinical management of coronary artery disease by visualizing thrombus formation.
- Cardiac magnetic resonance imaging (CMR) is a powerful tool for comprehensive cardiovascular assessment, including thrombus-related pathology.
- Continued development and translation of these imaging technologies promise future improvements in diagnosing and treating thrombotic cardiovascular events.
Abstract:
Coronary artery disease remains a major hazard within the western world despite early revascularisation and advanced medical therapy strategies. One of its major substrates is platelet activation and thrombus formation, triggering acute events such as myocardial infarction and ischemic strokes. There are a variety of non-invasive imaging strategies being translated from bench to bedside into clinical practice that tackle specific aspects of the pathophysiology of thrombus formation. Some of those techniques are able to visualize native contrast differences between thrombus and surrounding tissue, others focus on the use of specific contrast agents targeting thrombotic components such as fibrin or activated platelets. Some of those techniques are still in the pre-clinical stage; others have already entered the clinical arena. The current review article will introduce different techniques and their stage of development on their way from bench to bedside with a specific focus on cardiac magnetic resonance imaging, that has evolved over the last years providing high quality information on anatomy, perfusion and myocardial tissue characteristics such as scarring in clinical practice. Finally, we will give an outlook on how this exciting field might evolve in the future.
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