Vulnerable plaque imaging-current techniques.
Tremendous progress has been made over the past 30 years in the management of plaque rupture and acute coronary thrombosis. With the advent of new interventional cardiac techniques and concomitant advances in medical therapy, there has been a steady decline in cardiovascular mortality. Acute coronary syndromes, especially ST elevation myocardial infarction, still occur frequently and are associated with significant morbidity and mortality. As these events typically occur in lesions without severe pre-existing stenosis, interest has increased in identifying these "vulnerable plaques" and ultimately preventing myocardial infarction. Recently, several new invasive and non-invasive modalities have been developed to identify and better characterize vulnerable plaque. This review will cover the pathobiology of vulnerable plaque, current invasive and non-invasive imaging techniques, tissue characterization, and future applications of this exciting technology.
Hilty
K Chad
KC
Cardiology Division, Medical University of South Carolina, 25 Courtenay Drive, ART 7058, Box 592, Charleston, SC 29425, USA.
Steinberg
Daniel H
DH
D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D017023:Coronary Angiography; D003952:Diagnostic Imaging / Q000379:methods; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D006801:Humans; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D019265:Spectroscopy, Near-Infrared; D015899:Tomography, Emission-Computed, Single-Photon; D041623:Tomography, Optical Coherence; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional