Arithmetic of vulnerable plaques for noninvasive imaging.
Sudden cardiac death and acute myocardial infarction often occur as the first manifestation of coronary artery disease. Otherwise asymptomatic individuals with subclinical atherosclerosis almost always have a classic risk-factor profile and it is essential that they are identified before the occurrence of an acute coronary event. The ability to recognize such individuals requires the development of strategies that can localize unstable atherosclerotic lesions. Plaques that are vulnerable to rupture demonstrate distinct histological characteristics, including large plaque and necrotic core volumes, extensive remodeling of the vessel at the lesion site, and attenuated fibrous caps. Precise metrics of typical vulnerable atherosclerotic plaque dimensions will need to be defined to facilitate their identification by noninvasive imaging modalities.
Narula
Jagat
J
University of California Irvine School of Medicine, Orange, CA 92868-4080, USA. narula@uci.edu
Garg
Pankaj
P
Achenbach
Stephan
S
Motoyama
Sadako
S
Virmani
Renu
R
Strauss
H William
HW
D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional