Intracoronary Imaging of Coronary Atherosclerotic Plaque: From Assessment of Pathophysiological Mechanisms to Therapeutic Implication

• Published in: International journal of molecular sciences Vol. 24; no. 6; p. 5155
• Main Authors: Gurgoglione, Filippo Luca, Denegri, Andrea, Russo, Michele, Calvieri, Camilla, Benatti, Giorgio, Niccoli, Giampaolo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2023; MDPI
• Subjects: Acute Coronary Syndrome; Angiogenesis; Anti-inflammatory agents; Arteriosclerosis; Atherosclerosis; Atherosclerotic plaque; B cells; biological mechanisms; Brown, Arthur Joseph; Calcification; Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Coronary heart disease; Coronary vessels; Coronary Vessels - diagnostic imaging; Cytokines; Destabilization; Endothelium; Growth factors; Health aspects; Heart diseases; Homeostasis; Humans; Inflammation; intracoronary imaging; Lipids; Lymphocytes; Medical imaging; Morbidity; Mortality; Near infrared radiation; Pathophysiology; Permeability; Phenotypes; plaque healing; plaque vulnerability; Plaque, Atherosclerotic - diagnostic imaging; Proteins; Review; Risk factors; secondary prevention therapies; Smooth muscle; Spectroscopy, Near-Infrared - methods; Thrombosis; Tomography, Optical Coherence - methods; Tumor necrosis factor-TNF; Ultrasonography, Interventional - methods; coronary artery disease; secondary prevention therapies; intracoronary imaging; biological mechanisms; plaque healing; plaque vulnerability
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24065155

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality worldwide. Several cardiovascular risk factors are implicated in atherosclerotic plaque promotion and progression and are responsible for the clinical manifestations of coronary artery disease (CAD), ranging from chronic to acute coronary syndromes and sudden coronary death. The advent of intravascular imaging (IVI), including intravascular ultrasound, optical coherence tomography and near-infrared diffuse reflectance spectroscopy has significantly improved the comprehension of CAD pathophysiology and has strengthened the prognostic relevance of coronary plaque morphology assessment. Indeed, several atherosclerotic plaque phenotype and mechanisms of plaque destabilization have been recognized with different natural history and prognosis. Finally, IVI demonstrated benefits of secondary prevention therapies, such as lipid-lowering and anti-inflammatory agents. The purpose of this review is to shed light on the principles and properties of available IVI modalities along with their prognostic significance.