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Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques

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1st Cardiology Department, “Hippokration” General Hospital, Medical School, University of Athens, 11527 Athens, Greece
2
3rd Cardiology Department, Thoracic Diseases Hospital “Sotiria”, University of Athens Medical School, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2022, 8(4), 1742-1758; https://doi.org/10.3390/tomography8040147
Received: 6 June 2022 / Revised: 4 July 2022 / Accepted: 4 July 2022 / Published: 6 July 2022
Coronary atherosclerosis is a complex, multistep process that may lead to critical complications upon progression, revolving around plaque disruption through either rupture or erosion. Several high-risk features are associated with plaque vulnerability and may add incremental prognostic information. Although invasive imaging modalities such as optical coherence tomography or intravascular ultrasound are considered to be the gold standard in the assessment of vulnerable coronary atherosclerotic plaques (VCAPs), contemporary evidence suggests a potential role for non-invasive methods in this context. Biomarkers associated with deleterious pathophysiologic pathways, including inflammation and extracellular matrix degradation, have been correlated with VCAP characteristics and adverse prognosis. However, coronary computed tomography (CT) angiography has been the most extensively investigated technique, significantly correlating with invasive method-derived VCAP features. The estimation of perivascular fat attenuation as well as radiomic-based approaches represent additional concepts that may add incremental information. Cardiac magnetic resonance imaging (MRI) has also been evaluated in clinical studies, with promising results through the various image sequences that have been tested. As far as nuclear cardiology is concerned, the implementation of positron emission tomography in the VCAP assessment currently faces several limitations with the myocardial uptake of the radiotracer in cases of fluorodeoxyglucose use, as well as with motion correction. Moreover, the search for the ideal radiotracer and the most adequate combination (CT or MRI) is still ongoing. With a look to the future, the possible combination of imaging and circulating inflammatory and extracellular matrix degradation biomarkers in diagnostic and prognostic algorithms may represent the essential next step for the assessment of high-risk individuals. View Full-Text
Keywords: vulnerable plaque; atherosclerosis; coronary CT angiography; non-invasive imaging; biomarker vulnerable plaque; atherosclerosis; coronary CT angiography; non-invasive imaging; biomarker
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MDPI and ACS Style

Theofilis, P.; Sagris, M.; Antonopoulos, A.S.; Oikonomou, E.; Tsioufis, K.; Tousoulis, D. Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques. Tomography 2022, 8, 1742-1758. https://doi.org/10.3390/tomography8040147

AMA Style

Theofilis P, Sagris M, Antonopoulos AS, Oikonomou E, Tsioufis K, Tousoulis D. Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques. Tomography. 2022; 8(4):1742-1758. https://doi.org/10.3390/tomography8040147

Chicago/Turabian Style

Theofilis, Panagiotis, Marios Sagris, Alexios S. Antonopoulos, Evangelos Oikonomou, Konstantinos Tsioufis, and Dimitris Tousoulis. 2022. "Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques" Tomography 8, no. 4: 1742-1758. https://doi.org/10.3390/tomography8040147

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