Imaging of coronary atherosclerosis in various susceptible groups

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Pathophysiology

Background:

• Coronary artery disease (CAD) is a major global health burden, primarily caused by atherosclerosis.
• Atherosclerosis results from genetic and environmental factors including hypertension (HT), dyslipidaemia, diabetes mellitus (DM), smoking, obesity, and chronic kidney disease (CKD).
• Understanding plaque formation and progression is crucial for preventing CAD events.

Purpose of the Study:

• To review invasive and non-invasive imaging findings of coronary atherosclerosis.
• To examine plaque characteristics in high-risk populations: DM, metabolic syndrome, obesity, CKD, and diverse gender and ethnic groups.
• To explore how understanding plaque phenotypes can inform personalized treatment strategies.

Main Methods:

• Review of invasive intravascular imaging techniques: intravascular ultrasound (IVUS), Virtual histology IVUS (VH-IVUS), and optical coherence tomography (OCT).
• Review of non-invasive imaging techniques: coronary artery calcium (CAC) scoring and computed tomography coronary angiography (CTCA).
• Synthesis of findings from studies on various high-risk populations.

Main Results:

• Invasive and non-invasive imaging provide detailed in vivo assessment of plaque burden, morphology, and stenosis.
• Specific plaque phenotypes are observed in different high-risk groups, including those with DM, metabolic syndrome, obesity, and CKD.
• Gender and ethnic variations in atherosclerosis are evident.

Conclusions:

• Imaging modalities are essential for characterizing coronary atherosclerosis in diverse populations.
• Identifying distinct plaque phenotypes in susceptible groups is key to advancing personalized CAD therapies.
• Further research into population-specific atherosclerosis can optimize risk stratification and treatment approaches.