Imaging Biomarkers for Plaque Vulnerability Assessment

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2023, Volume 1, Issue 3 : 1-5

Research Article

Imaging Biomarkers for Plaque Vulnerability Assessment

Daniel R. Wilson

Ayesha N. Rahman

Marco L. Silva

Priya K. Sharma

⁴

Department of Interventional Cardiology, Global Heart Institute, Boston, USA

Division of Cardiovascular Imaging, Royal Medical Centre, London, UK

Department of Biomedical Imaging, European Cardiac Research Centre, Lisbon, Portugal

⁴

Department of Cardiology, Institute of Cardiovascular Sciences, New Delhi, India

Abstract

Background: Vulnerable atherosclerotic plaques are lesions prone to rupture or erosion, leading to acute coronary syndrome. Conventional angiography evaluates luminal stenosis but does not reliably identify plaque composition or biological instability.

Objective: To evaluate imaging biomarkers associated with plaque vulnerability using coronary CT angiography, intravascular ultrasound, optical coherence tomography, near-infrared spectroscopy, and emerging hybrid imaging methods.

Methods: This narrative research article reviews contemporary imaging biomarkers of vulnerable plaque and presents a dummy observational dataset of 320 patients undergoing multimodality coronary plaque assessment.

Results: Major vulnerability biomarkers included thin fibrous cap, large lipid-rich necrotic core, positive remodeling, low attenuation plaque, spotty calcification, macrophage infiltration, microchannels, plaque burden, and high lipid-core burden index.

Conclusion: Imaging biomarkers provide essential insight beyond stenosis severity and may improve risk stratification, preventive therapy selection, and interventional planning.

Keywords

Vulnerable plaque

Coronary artery disease

OCT

IVUS

NIRS

CCTA

Plaque rupture

Imaging biomarkers

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