Lipids and cardiovascular calcification: contributions to plaque vulnerability

Area of Science:

• Cardiovascular Medicine
• Atherosclerosis Research
• Medical Imaging

Background:

• Cardiovascular calcification is a common hallmark of atherosclerotic lesions, linked to increased cardiovascular risk.
• Lipoproteins play established roles in atherosclerosis, with lipid-modifying therapies capable of plaque regression.
• The interplay between lipid-modifying therapies and cardiovascular calcification is complex, with no current treatments to reverse calcification.

Purpose of the Study:

• To review recent advancements in understanding the relationship between lipids and cardiovascular calcification.
• To explore novel imaging modalities for assessing the vulnerability of calcified atherosclerotic plaque.

Main Methods:

• Review of recent clinical studies and emerging evidence on lipoprotein associations with calcification.
• Evaluation of 18F-sodium fluoride positron-emission tomographic and computed tomographic (18F-NaF PET/CT) imaging for plaque characterization.

Main Results:

• Lipoprotein subtypes (LDL, HDL, Lp(a)) are associated with coronary calcification and calcific aortic valve disease.
• 18F-NaF PET/CT imaging shows utility in characterizing atherosclerotic plaque microarchitecture and vulnerability in humans and animal models.

Conclusions:

• The relationship between lipids and cardiovascular calcification is intricate.
• Advanced imaging techniques like 18F-NaF PET/CT may aid in identifying disease-modifying therapies and predicting calcified plaque progression and stability for clinical management.