Article, 2024

Noninvasive Atherosclerotic Phenotyping: The Next Frontier into Understanding the Pathobiology of Coronary Artery Disease

Current Atherosclerosis Reports, ISSN 1523-3804, 1534-6242, Volume 26, 7, Pages 305-315, 10.1007/s11883-024-01205-7

Contributors

Wolny, Rafał R [1] Geers, Jolien 0000-0003-1109-5191 [2] [3] [4] Grodecki, Kajetan Łukasz 0000-0002-0358-5679 [4] [5] Kwiecinski, Jacek [1] Williams, Michelle Claire 0000-0003-3556-2428 [6] Slomka, Piotr Jan 0000-0002-6110-938X [4] Hasific, Selma 0000-0001-7654-8492 [4] [7] Lin, Andrew K 0000-0003-0348-7697 [4] [8] Dey, Damini 0000-0003-2236-6970 (Corresponding author) [4]

Affiliations

  1. [1] Institute of Cardiology
  2. [NORA names: Poland; Europe, EU; OECD];
  3. [2] Universitair Ziekenhuis Brussel
  4. [NORA names: Belgium; Europe, EU; OECD];
  5. [3] Vrije Universiteit Brussel
  6. [NORA names: Belgium; Europe, EU; OECD];
  7. [4] Cedars-Sinai Medical Center
  8. [NORA names: United States; America, North; OECD];
  9. [5] Medical University of Warsaw
  10. [NORA names: Poland; Europe, EU; OECD];

Abstract

Purpose of ReviewDespite recent advances, coronary artery disease remains one of the leading causes of mortality worldwide. Noninvasive imaging allows atherosclerotic phenotyping by measurement of plaque burden, morphology, activity and inflammation, which has the potential to refine patient risk stratification and guide personalized therapy. This review describes the current and emerging roles of advanced noninvasive cardiovascular imaging methods for the assessment of coronary artery disease.Recent FindingsCardiac computed tomography enables comprehensive, noninvasive imaging of the coronary vasculature, and is used to assess luminal stenoses, coronary calcifications, and distinct adverse plaque characteristics, helping to identify patients prone to future events. Novel software tools, implementing artificial intelligence solutions, can automatically quantify and characterize atherosclerotic plaque from standard computed tomography datasets. These quantitative imaging biomarkers have been shown to improve patient risk stratification beyond clinical risk scores and current clinical interpretation of cardiac computed tomography. In addition, noninvasive molecular imaging in higher risk patients can be used to assess plaque activity and plaque thrombosis.SummaryNoninvasive imaging allows unique insight into the burden, morphology and activity of atherosclerotic coronary plaques. Such phenotyping of atherosclerosis can potentially improve individual patient risk prediction, and in the near future has the potential for clinical implementation.

Keywords

activity, advances, adverse plaque characteristics, artery disease, artificial intelligence solutions, assessment, assessment of coronary artery disease, atherosclerosis, atherosclerotic coronary plaques, atherosclerotic phenotype, atherosclerotic plaques, biomarkers, burden, calcification, cardiac computed tomography, characteristics, clinical implementation, clinical interpretation, clinical risk score, computed tomography datasets, coronary artery disease, coronary calcification, coronary plaques, coronary vasculature, dataset, disease, events, frontier, future, high-risk patients, images, imaging biomarkers, imaging methods, implementation, improve patient risk stratification, inflammation, intelligent solutions, luminal stenosis, measurements, measures of plaque burden, method, molecular imaging, morphology, mortality, near future, next frontiers, noninvasive imaging, noninvasive molecular imaging, novel software tool, pathobiology, pathobiology of coronary artery disease, patient risk prediction, patient risk stratification, patients, personalized therapy, phenotype, phenotypes of atherosclerosis, plaque, plaque activity, plaque burden, plaque characteristics, plaque thrombosis, potential, prediction, purposes, quantitative imaging biomarkers, recent advances, review, risk patients, risk prediction, risk score, risk stratification, scores, software tools, solution, stenosis, stratification, therapy, thrombosis, tomography, tomography datasets, tools, vasculature

Funders

  • Research Foundation - Flanders
  • British Heart Foundation
  • Foundation for Polish Science
  • Adelson Foundation
  • National Science Center
  • National Heart Lung and Blood Institute

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