Interactions Between Morphological Plaque Characteristics and Coronary Physiology: From Pathophysiological Basis to...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Imaging

Background:

• High-risk coronary plaque characteristics are linked to future coronary events.
• Coronary physiology indexes reflect local hemodynamics and vascular function.
• Current methods for plaque identification and physiological assessment have limitations in predicting clinical events.

Purpose of the Study:

• To review the pathophysiological interplay between coronary plaque morphology and coronary physiology.
• To explore the complementary role of plaque morphology and physiology in prognostication.
• To propose an integrative assessment approach for personalized risk stratification and treatment.

Main Methods:

• Review of clinical evidence on the interaction between plaque characteristics and physiological indexes.
• Examination of data on the combined prognostic value of morphology and physiology.
• Discussion of the application of integrative assessment in clinical practice.

Main Results:

• Plaque morphology alone does not reliably identify lesions causing major adverse cardiovascular events.
• Guideline-directed physiological assessments do not fully predict or prevent clinical events.
• Evidence suggests an interplay between plaque morphology and coronary physiology with clinical implications.

Conclusions:

• An integrative assessment combining coronary anatomy, plaque characteristics, and physiological data can enhance risk profiling.
• This comprehensive approach may overcome the limitations of individual assessments.
• Personalized risk stratification and optimized treatment strategies can be achieved through integrated evaluation.