title: Vulnerable plaque imaging: updates on new pathobiological mechanisms.
abstract: Early identification of vulnerable, rupture-prone atherosclerotic plaques with the optimal goal of cardiovascular event prevention is a field of vigorous research. Despite the advances in imaging modalities and the in vivo identification of many characteristics of vulnerability, few of these plaques actually rupture and even fewer lead to clinical events, questioning the predictive value of the above techniques in clinical practice. Factors causing the higher local vulnerability of the culprit plaque within a prothrombotic environment of widespread inflammation are generally unknown. Newly recognized local features, including microcalcifications and biomechanical factors, seem to contribute. In this review article, we target on new mechanisms, implicated in vulnerable plaque formation and rupture, analysing their potential clinical value.
authors.affiliation: First Department of Cardiology, Hippokration Hospital, Athens Medical School, 114 Vasilissis Sofias Av., 11527 Athens, Greece ktoutouz@gmail.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.affiliation: First Department of Cardiology, Hippokration Hospital, Athens Medical School, 114 Vasilissis Sofias Av., 11527 Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Benetos
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Antonios
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Chatzizisis
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Giannopoulos
authors.affiliation: First Department of Cardiology, Hippokration Hospital, Athens Medical School, 114 Vasilissis Sofias Av., 11527 Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D057791:Cardiac Imaging Techniques; D002784:Cholesterol / Q000378:metabolism; D003460:Crystallization; D004730:Endothelium, Vascular / Q000502:physiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D035683:MicroRNAs / Q000502:physiology; D058226:Plaque, Atherosclerotic / Q000209:etiology* / Q000473:pathology; D012422:Rupture, Spontaneous / Q000209:etiology / Q000473:pathology; D013312:Stress, Physiological / Q000502:physiology; D061205:Vascular Calcification / Q000209:etiology / Q000473:pathology; D014657:Vasculitis / Q000473:pathology
chemical_list: D035683:MicroRNAs; D002784:Cholesterol
keywords: Endothelial shear stress; Inflammation; MiRNAs; Microcalcifications; Vulnerable plaque