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Biccirè FG, Gatto L, La Porta Y, Pignatelli P, Prati F, Pastori D. Effects of Lipid Lowering Therapies on Vulnerable Plaque Features: An Updated Narrative Review of the Literature. J Cardiovasc Dev Dis 2023; 10:260. [PMID: 37367425 DOI: 10.3390/jcdd10060260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
The clinical evidence on the efficacy of lipid lowering therapy in patients with coronary artery disease (CAD) is unequivocally established. However, the effects of these therapies on plaque composition and stability are less clear. The use of intracoronary imaging (ICI) technologies has emerged as a complement to conventional angiography to further characterize plaque morphology and detect high-risk plaque features related to cardiovascular events. Along with clinical outcomes studies, parallel imaging trials employing serial evaluations with intravascular ultrasound (IVUS) have shown that pharmacological treatment has the capacity to either slow disease progression or promote plaque regression, depending on the degree of lipid lowering achieved. Subsequently, the introduction of high-intensity lipid lowering therapy led to much lower levels of low-density lipoprotein cholesterol (LDL-C) levels than achieved in the past, resulting in greater clinical benefit. However, the degree of atheroma regression showed in concomitant imaging trials appeared more modest as compared to the magnitude of clinical benefit accrued from high-intensity statin therapy. Recently, new randomized trials have investigated the additional effects of achieving very low levels of LDL-C on high-risk plaque features-such as fibrous cap thickness and large lipid accumulation-beyond its size. This paper provides an overview of the currently available evidence of the effects of moderate to high-intensity lipid lowering therapy on high-risk plaque features as assessed by different ICI modalities, reviews data supporting the use of these trials, and analyse the future perspectives in this field.
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Affiliation(s)
- Flavio Giuseppe Biccirè
- Department of General and Specialized Surgery "Paride Stefanini", Sapienza University of Rome, 00185 Rome, Italy
- Centro per la Lotta Contro L'Infarto-CLI Foundation, 00182 Rome, Italy
| | - Laura Gatto
- Centro per la Lotta Contro L'Infarto-CLI Foundation, 00182 Rome, Italy
- Department of Cardiovascular Sciences, San Giovanni Hospital, 00184 Rome, Italy
| | - Ylenia La Porta
- Centro per la Lotta Contro L'Infarto-CLI Foundation, 00182 Rome, Italy
- Department of Medicine, Campus Bio-Medical University, 00128 Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Prati
- Centro per la Lotta Contro L'Infarto-CLI Foundation, 00182 Rome, Italy
- Department of Cardiovascular Sciences, San Giovanni Hospital, 00184 Rome, Italy
- Saint Camillus International Medical University, 00131 Rome, Italy
| | - Daniele Pastori
- Department of Clinical Internal, Anesthesiological, and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
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2
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Kocyigit D, Scanameo A, Xu B. Multimodality imaging for the prevention of cardiovascular events: Coronary artery calcium and beyond. Cardiovasc Diagn Ther 2021; 11:840-858. [PMID: 34295709 PMCID: PMC8261752 DOI: 10.21037/cdt-19-654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/15/2020] [Indexed: 12/24/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) has been the leading cause of death worldwide for more than a decade. Prevention is of utmost importance to reduce related mortality. The innovations in cardiovascular imaging technology, in addition to our improved understanding of coronary atherosclerosis pathogenesis, have resulted in cardiovascular imaging becoming one of the most influential tools for diagnosis and risk stratification in ASCVD. Although numerous publications have emerged on this topic, data that guide routine cardiology clinical practice currently focus on the utility of a limited number of such modalities, namely arterial ultrasonography and computed tomography. Herein, current evidence with respect to the role of multimodality cardiovascular imaging on ASCVD prevention will be reviewed.
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Affiliation(s)
- Duygu Kocyigit
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Bo Xu
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
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3
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Liu W, Balu N, Canton G, Hippe DS, Watase H, Waterton JC, Hatsukami T, Yuan C. Understanding Atherosclerosis Through an Osteoarthritis Data Set. Arterioscler Thromb Vasc Biol 2020; 39:1018-1025. [PMID: 31070477 DOI: 10.1161/atvbaha.119.312513] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Atherosclerotic cardiovascular disease remains a worldwide epidemic and one of the leading causes of death nowadays. Vessel wall imaging can be used to understand the development and progression of atherosclerosis, but it is rarely done because of the high cost. We recently identified the Osteoarthritis Initiative, a large prospective cohort study of knee osteoarthritis, which might serve as a valuable source for atherosclerosis research with its serial knee magnetic resonance imaging data. We have found that these images are suitable for vessel wall image analysis of the lower extremity arteries. Here, we will introduce the Osteoarthritis Initiative data set and explain why it could be used for cardiovascular research purposes. Also, we will briefly comment on peripheral artery atherosclerosis as it is covered in the Osteoarthritis Initiative image data set and review the use of vessel wall imaging for studying atherosclerosis. We think data mining of imaging studies, not originally designed on cardiovascular research, can not only maximize the value of the imaging data set but also boost our understanding of atherosclerosis.
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Affiliation(s)
- Wenjin Liu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Niranjan Balu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Gador Canton
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Daniel S Hippe
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Hiroko Watase
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - John C Waterton
- Centre for Imaging Sciences, Manchester Academic Health Science Centre, The University of Manchester, United Kingdom (J.C.W.)
| | - Thomas Hatsukami
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - Chun Yuan
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
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4
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Harteveld AA, Denswil NP, Van Hecke W, Kuijf HJ, Vink A, Spliet WGM, Daemen MJ, Luijten PR, Zwanenburg JJM, Hendrikse J, van der Kolk AG. Ex vivo vessel wall thickness measurements of the human circle of Willis using 7T MRI. Atherosclerosis 2018; 273:106-114. [PMID: 29715587 DOI: 10.1016/j.atherosclerosis.2018.04.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/30/2018] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS MRI can detect intracranial vessel wall thickening before any luminal stenosis is present. Apart from representing a vessel wall lesion, wall thickening could also reflect normal (age-related) variations in vessel wall thickness present throughout the intracranial arterial vasculature. The aim of this study was to perform vessel wall thickness measurements of the major intracranial arteries in ex vivo circle of Willis (CoW) specimens using 7T MRI, to obtain more detailed information about wall thickness variations of the intracranial arteries. METHODS Fifteen human CoW specimens were scanned at 7T MRI with an ultrahigh-resolution T1-weighted sequence. Five specimens were used for validation of MRI measurements with histology and evaluation of inter-rater reliability and agreement. The other 10 specimens from patients with (n = 5) and without (n = 5) cerebrovascular disease were used for vessel wall thickness measurements over the entire length of the major arterial segments of the CoW using MRI only. RESULTS MRI measurements showed excellent agreement with histology. Mean wall thickness varied from 0.45 to 0.66 mm, minimum wall thickness from 0.31 to 0.42 mm, maximum wall thickness from 0.52 to 0.86 mm, and normalized wall index from 0.64 to 0.75. On average, vessel walls were thicker for symptomatic patients compared to asymptomatic patients. CONCLUSIONS High-resolution MRI enables accurate measurement of vessel wall thickness in ex vivo CoW specimens. Vessel wall thickness measurements over the entire length of segments showed considerable variation both within and between arterial segments of patients.
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Affiliation(s)
- Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands.
| | - Nerissa P Denswil
- Department of Pathology, Academic Medical Center, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Wim Van Hecke
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Wim G M Spliet
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Mat J Daemen
- Department of Pathology, Academic Medical Center, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Peter R Luijten
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Anja G van der Kolk
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
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5
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Jansen CHP, Perera D, Wiethoff AJ, Phinikaridou A, Razavi RM, Rinaldi A, Marber MS, Greil GF, Nagel E, Maintz D, Redwood S, Botnar RM, Makowski MR. Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. PLoS One 2017; 12:e0188292. [PMID: 29190694 PMCID: PMC5708680 DOI: 10.1371/journal.pone.0188292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.
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Affiliation(s)
- Christian H. P. Jansen
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- * E-mail:
| | - Divaka Perera
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Andrea J. Wiethoff
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- Philips Healthcare, Guildford, United Kingdom
| | - Alkystis Phinikaridou
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Reza M. Razavi
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - Aldo Rinaldi
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Mike S. Marber
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Gerald F. Greil
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Eike Nagel
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - David Maintz
- Department of Radiology, University Muenster, Muenster, Germany
| | - Simon Redwood
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Rene M. Botnar
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
- Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Marcus R. Makowski
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Department of Radiology, Charité, Berlin, Germany
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6
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Yoneyama K, Venkatesh BA, Bluemke DA, McClelland RL, Lima JAC. Cardiovascular magnetic resonance in an adult human population: serial observations from the multi-ethnic study of atherosclerosis. J Cardiovasc Magn Reson 2017; 19:52. [PMID: 28720123 PMCID: PMC5514469 DOI: 10.1186/s12968-017-0367-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
The Multi-Ethnic Study of Atherosclerosis (MESA) is the first large-scale multi-ethnic population study in the U.S. to use advanced cardiovascular magnetic resonance (CMR) imaging. MESA participants were free of cardiovascular disease at baseline between 2000 and 2002, and were followed up between 2009 and 2011 with repeated CMR examinations as part of MESA. CMR allows the clinician to visualize and accurately quantify volume and dimensions of all four cardiac chambers; measure systolic and diastolic ventricular function; assess myocardial fibrosis; assess vessel lumen size, vessel wall morphology, and vessel stiffness. CMR has a number of advantages over other imaging modalities such as echocardiography, computed tomography, and invasive angiography, and has been proposed as a diagnostic strategy for high-risk populations. MESA has been extensively evaluating CMR imaging biomarkers, as markers of subclinical disease, in the last 15 years for low-risk populations. On a more practical level, some of the imaging biomarkers developed and studied are translatable to at-risk populations. In this review, we discuss the progression of subclinical cardiovascular disease and the mechanisms responsible for the transition to symptomatic clinical outcomes based on our findings from MESA.
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Grants
- N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169, UL1-TR-000040 and UL1-TR-001079
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Affiliation(s)
- Kihei Yoneyama
- Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA
- St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | | | - João A C Lima
- Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.
- Professor of Medicine, Radiology and Epidemiology, Johns Hopkins Hospital, Johns Hopkins University, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
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Paiman EHM, Lamb HJ. When should we use contrast material in cardiac MRI? J Magn Reson Imaging 2017; 46:1551-1572. [PMID: 28480596 DOI: 10.1002/jmri.25754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/18/2017] [Indexed: 12/29/2022] Open
Abstract
At present, most of the cardiac magnetic resonance imaging (MRI) examinations rely on contrast-enhanced protocols, but noncontrast alternatives are emerging. Late gadolinium enhancement (LGE) imaging for the detection of myocardial scar can be considered the main cause for the embedding of cardiac MRI into the clinical routine. The novel noncontrast technique of native T1 mapping shows promise for tissue characterization in ischemic and nonischemic cardiomyopathy and may provide additional information over conventional LGE imaging. Technical issues, including measurements variability, still need to be resolved to facilitate a wide clinical application. Ischemia detection can be performed with contrast-based stress perfusion and contrast-free stress wall motion imaging. For coronary magnetic resonance angiography (MRA), protocols with and without contrast material have been developed. Research on coronary atherosclerotic plaque characterization has introduced new applications of contrast material. For MRA of the aorta, which traditionally relied on contrast administration, several noncontrast protocols have become available. This review provides an overview of when to use contrast material in cardiac and cardiac-related vascular MRI, summarizes the major imaging building blocks, and describes the diagnostic value of the available contrast-enhanced and noncontrast techniques. Contrast material in cardiac MRI should be used for LGE imaging for tissue characterization in ischemic or nonischemic cardiomyopathy and may be used for stress perfusion imaging for the detection of ischemia. In cardiac-related vascular MRI, use of contrast material should be avoided, unless high-quality angiography is required that cannot be obtained with noncontrast protocols. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1551-1572.
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Affiliation(s)
- Elisabeth H M Paiman
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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8
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He Y, Da Q, An J, Song X, Li D. Coronary artery plaque imaging: Comparison of black‐blood MRI and 64‐multidetector computed tomography. Chronic Dis Transl Med 2016; 2:159-165. [PMID: 29063037 PMCID: PMC5643764 DOI: 10.1016/j.cdtm.2016.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Indexed: 12/02/2022] Open
Abstract
Objective To comparatively evaluate black-blood coronary arterial wall MRI and 64-multidetector computed tomography (64-MDCT) for detection and classification of coronary artery plaques. Methods We included 15 patients with confirmed coronary artery plaques in the proximal or middle segments of coronary arteries by 64-MDCT, who underwent black-blood coronary wall MRI at 1.5 T within 10 days. Cross-sectional coronary wall images were acquired using a 2D double-inversion-recovery, electrocardiograph-triggered, navigator-gated, fat-suppressed, turbo-spin-echo sequence on the coronary arteries with lesions from the ostium to the middle segment continuously without gap. The vessel cross-sectional area (CSA), luminal CSA, maximal wall thickness, plaque burden, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were measured in each slice and subsequently compared with computed tomography angiography (CTA) images. CTA images were divided into 5-mm segments for side-by-side comparison with MRI. Results Of the 15 patients, 12 were enrolled in the study. Coronary plaques were found in 46 slices on both CTA and MRI. Plaques were classified to 3 groups based on CTA: calcified plaques (n = 11), soft plaques (n = 23), and mixed plaques (n = 12). In MRI, the plaque burden, maximal wall thickness, SNR, and CNR in the coronary walls containing plaques were greater than in the normal coronary walls (0.83 ± 0.08 vs. 0.73 ± 0.08, 1.88 ± 0.51 vs. 1.51 ± 0.26 mm, 12.95 ± 2.78 vs. 9.93 ± 2.31, and 6.76 ± 2.52 vs. 3.89 ± 1.54, respectively; P < 0.05). The luminal CSA at the plaque was smaller than in normal coronary walls (2.50 ± 1.50 vs. 4.72 ± 2.28 mm2; P < 0.05). The SNR in the soft plaque was significantly greater than in calcified and mixed plaques (P < 0.05). Conclusions Coronary wall MRI can identify coronary plaques in the proximal and middle segments and has the potential to differentiate plaque types based on signal intensity.
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Affiliation(s)
- Yi He
- Department of RadiologyBeijing Institute of Heart, Lung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijing100029China
| | - Qin‐Yi Da
- Department of RadiologyBeijing Institute of Heart, Lung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijing100029China
| | - Jing An
- Siemens HealthcareMR Collaboration NE AsiaBeijing100102China
| | - Xian‐Tao Song
- Department of CardiologyBeijing Institute of Heart, Lung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijing100029China
| | - De‐Biao Li
- Cedars‐Sinai Medical CenterUniversity of CaliforniaLos AngelesUSA
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9
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Dweck MR, Puntmann VO, Vesey AT, Fayad ZA, Nagel E. MR Imaging of Coronary Arteries and Plaques. JACC Cardiovasc Imaging 2016; 9:306-16. [DOI: 10.1016/j.jcmg.2015.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/25/2015] [Accepted: 12/03/2015] [Indexed: 01/13/2023]
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10
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Ginami G, Yerly J, Masci PG, Stuber M. Golden angle dual-inversion recovery acquisition coupled with a flexible time-resolved sparse reconstruction facilitates sequence timing in high-resolution coronary vessel wall MRI at 3 T. Magn Reson Med 2016; 77:961-969. [PMID: 26900941 DOI: 10.1002/mrm.26171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/15/2015] [Accepted: 01/27/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE The need for performing dual-inversion recovery (DIR) coronary vessel wall MRI in correspondence to minimal cardiac motion and optimal blood signal nulling is a major challenge. We propose to address this hurdle by combining DIR with a prolonged acquisition window in conjunction with a golden angle radial trajectory and k-t sparse sensitivity encoding (SENSE) reconstruction to enable a flexible a-posteriori selection of optimized imaging parameters. METHODS Coronary vessel wall data acquisition was performed with DIR golden angle radial imaging in n=15 healthy subjects. Images reconstructed using k-t sparse SENSE and different reconstruction window settings were quantitatively (vessel wall conspicuity, thickness, acquisition, and reconstruction window settings) compared with those obtained with more conventional radial DIR imaging. RESULTS A flexible retrospective selection of the reconstruction window width and position improved vessel wall conspicuity with respect to baseline acquisitions (P < 0.01). Vessel wall thickness remained unchanged (P = nonsignificant (NS)). Temporal window widths were similar for both approaches (P = NS), yet their position within the cardiac cycle differed significantly (P < 0.02). CONCLUSIONS A flexible DIR coronary vessel wall MRI technique that alleviates constraints associated with sophisticated sequence timing was proposed. When compared with a more conventional approach, the technique significantly improved image quality. Magn Reson Med 77:961-969, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Giulia Ginami
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Centre for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Pier Giorgio Masci
- Division of Cardiology and Cardiac MR Center, University Hospital (CHUV), Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Centre for Biomedical Imaging (CIBM), Lausanne, Switzerland
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11
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Sandfort V, Lima JAC, Bluemke DA. Noninvasive Imaging of Atherosclerotic Plaque Progression: Status of Coronary Computed Tomography Angiography. Circ Cardiovasc Imaging 2015; 8:e003316. [PMID: 26156016 DOI: 10.1161/circimaging.115.003316] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The process of coronary artery disease progression is infrequently visualized. Intravascular ultrasound has been used to gain important insights but is invasive and therefore limited to high-risk patients. For low-to-moderate risk patients, noninvasive methods may be useful to quantitatively monitor plaque progression or regression and to understand and personalize atherosclerosis therapy. This review discusses the potential for coronary computed tomography angiography to evaluate the extent and subtypes of coronary plaque. Computed tomographic technology is evolving and image quality of the method approaches the level required for plaque progression monitoring. Methods to quantify plaque on computed tomography angiography are reviewed as well as a discussion of their use in clinical trials. Limitations of coronary computed tomography angiography compared with competing modalities include limited evaluation of plaque subcomponents and incomplete knowledge of the value of the method especially in patients with low-to-moderate cardiovascular risk.
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Affiliation(s)
- Veit Sandfort
- From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD
| | - Joao A C Lima
- From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD
| | - David A Bluemke
- From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD.
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12
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Eckel RH, Cornier MA. Update on the NCEP ATP-III emerging cardiometabolic risk factors. BMC Med 2014; 12:115. [PMID: 25154373 PMCID: PMC4283079 DOI: 10.1186/1741-7015-12-115] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/20/2014] [Indexed: 12/31/2022] Open
Abstract
The intent of this review is to update the science of emerging cardiometabolic risk factors that were listed in the National Cholesterol Education Program (NCEP) Adult Treatment Panel-III (ATP-III) report of 2001 (updated in 2004). At the time these guidelines were published, the evidence was felt to be insufficient to recommend these risk factors for routine screening of cardiovascular disease risk. However, the panel felt that prudent use of these biomarkers for patients at intermediate risk of a major cardiovascular event over the subsequent 10 years might help identify patients who needed more aggressive low density lipoprotein (LDL) or non-high density lipoprotein (HDL) cholesterol lowering therapy. While a number of other emerging risk factors have been identified, this review will be limited to assessing the data and recommendations for the use of apolipoprotein B, lipoprotein (a), homocysteine, pro-thrombotic factors, inflammatory factors, impaired glucose metabolism, and measures of subclinical atherosclerotic cardiovascular disease for further cardiovascular disease risk stratification.
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Affiliation(s)
- Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, Mail Stop 8106, 12801 E 17th Ave, Aurora, CO 80045 USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, Mail Stop 8106, 12801 E 17th Ave, Aurora, CO 80045 USA
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Garcia-Garcia HM, Jang IK, Serruys PW, Kovacic JC, Narula J, Fayad ZA. Imaging plaques to predict and better manage patients with acute coronary events. Circ Res 2014; 114:1904-17. [PMID: 24902974 DOI: 10.1161/circresaha.114.302745] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Culprit lesions of patients, who have had an acute coronary syndrome commonly, are ruptured coronary plaques with superimposed thrombus. The precursor of such lesions is an inflamed thin-capped fibroatheroma. These plaques can be imaged by means of invasive techniques, such as intravascular ultrasound (and derived techniques), optical coherence tomography, and near-infrared spectroscopy. Often these patients exhibit similar (multiple) plaques beyond the culprit lesion. These remote plaques can be assessed noninvasively by computed tomographic angiography and MRI and also using invasive imaging. The detection of these remote plaques is not only feasible but also in natural history studies have been associated with clinical coronary events. Different systemic pharmacological treatments have been studied (mostly statins) with modest success and, therefore, newer approaches are being tested. Local treatment for such lesions is in its infancy and larger, prospective, and randomized trials are needed. This review will describe the pathological and imaging findings in culprit lesions of patients with acute coronary syndrome and the assessment of remote plaques. In addition, the pharmacological and local treatment options will be reviewed.
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Affiliation(s)
- Hector M Garcia-Garcia
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ik-Kyung Jang
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patrick W Serruys
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jason C Kovacic
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jagat Narula
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zahi A Fayad
- From the Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands (H.M.G.-G., P.W.S.); Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (I.-K.J.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Cardiovascular Research Center (J.C.K., J.N., Z.A.F.) and Department of Radiology, Translational and Molecular Imaging Institute (Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY.
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Kuo YS, Kelle S, Lee C, Hinojar R, Nagel E, Botnar R, Puntmann VO. Contrast-enhanced cardiovascular magnetic resonance imaging of coronary vessel wall: state of art. Expert Rev Cardiovasc Ther 2014; 12:255-63. [PMID: 24417398 DOI: 10.1586/14779072.2014.877838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronary wall imaging by cardiovascular magnetic resonance (CMR) emerges as a promising method to detect vascular injury and remodeling directly within the coronary vascular wall. In this review, the current evidence on coronary wall enhancement using CMR is presented and summarized, with particular focus on its ability to detect inflammation in atherosclerosis, Takayasu's arteritis, acute coronary syndromes and immune-mediated inflammatory vasculitides. The authors review the possible mechanisms of coronary wall contrast enhancement on CMR and discuss the technical considerations and limitations. Lastly, the potential clinical applications and possibilities for future research are proposed.
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Affiliation(s)
- Yen-Shu Kuo
- Department of Cardiovascular Imaging, The Rayne Institute, King's College London, London, UK
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15
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Makowski MR, Henningsson M, Spuentrup E, Kim WY, Maintz D, Manning WJ, Botnar RM. Characterization of coronary atherosclerosis by magnetic resonance imaging. Circulation 2013; 128:1244-55. [PMID: 24019445 DOI: 10.1161/circulationaha.113.002681] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marcus R Makowski
- Division of Imaging Sciences and Biomedical Engineering (M.R.M., M.H., R.M.B.), BHF Center of Research Excellence (M.R.M., M.H., R.M.B.), Wellcome Trust and EPSRC Medical Engineering Center (M.H., R.M.B.), and NIHR Biomedical Research Center (M.H., R.M.B.), King's College London, London, UK; Department of Radiology, Charité, Berlin, Germany (M.R.M.); Department of Radiology and Nuclear Medicine, Hospital Saarbrucken, Saarbrucken, Germany (E.S.); Department of Cardiology, Aarhus University Hospital, Skejby Sygehus, Denmark (W.Y.K.); Department of Radiology, University of Cologne, Cologne, Germany (D.M.); and Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (W.J.M.)
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16
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Gharib AM, Zahiri H, Matta J, Pettigrew RI, Abd-Elmoniem KZ. Feasibility of coronary artery wall thickening assessment in asymptomatic coronary artery disease using phase-sensitive dual-inversion recovery MRI at 3T. Magn Reson Imaging 2013; 31:1051-8. [PMID: 23642801 PMCID: PMC3729736 DOI: 10.1016/j.mri.2013.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 02/26/2013] [Accepted: 03/09/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The purpose of this study was to (a) investigate the image quality of phase-sensitive dual-inversion recovery (PS-DIR) coronary wall imaging in healthy subjects and in subjects with known coronary artery disease (CAD) and to (b) investigate the utilization of PS-DIR at 3T in the assessment of coronary artery thickening in subjects with asymptomatic but variable degrees of CAD. MATERIALS AND METHODS A total of 37 subjects participated in this institutional review board-approved and HIPAA-compliant study. These included 21 subjects with known CAD as identified on multidetector computed tomography angiography (MDCT). Sixteen healthy subjects without known history of CAD were included. All subjects were scanned using free-breathing PS-DIR magnetic resonance imaging (MRI) for the assessment of coronary wall thickness at 3T. Lumen-tissue contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) and quantitative vessel parameters including lumen area and wall thickness were measured. Statistical analyses were performed. RESULTS PS-DIR was successfully completed in 76% of patients and in 88% of the healthy subjects. Phase-sensitive signed-magnitude reconstruction, compared to modulus-magnitude images, significantly improved lumen-tissue CNR in healthy subjects (26.73±11.95 vs. 14.65±9.57, P<.001) and in patients (21.45±7.61 vs. 16.65±5.85, P<.001). There was no difference in image CNR and SNR between groups. In arterial segments free of plaques, coronary wall was thicker in patients in comparison to healthy subjects (1.74±0.27 mm vs. 1.17±0.14 mm, P<.001), without a change in lumen area (4.51±2.42 mm2 vs. 5.71±3.11mm2, P=.25). CONCLUSIONS This is the first study to demonstrate the feasibility of successfully obtaining vessel wall images at 3T using PS-DIR in asymptomatic patients with known variable degrees of CAD as detected by MDCT. This was achieved with a fixed subject-invariant planning of blood signal nulling. With that limitation alleviated, PS-DIR coronary wall MRI is capable of detecting arterial thickening and positive arterial remodeling at 3T in asymptomatic CAD.
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Affiliation(s)
- Ahmed M Gharib
- Biomedical and Metabolic Imaging Branch, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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17
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Yang J, Li T, Cui X, Zhou W, Li X, Zhang X. Optimizing the imaging protocol for ex vivo coronary artery wall using high-resolution MRI: an experimental study on porcine and human. Korean J Radiol 2013; 14:581-8. [PMID: 23901315 PMCID: PMC3725352 DOI: 10.3348/kjr.2013.14.4.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 03/24/2013] [Indexed: 11/18/2022] Open
Abstract
Objective To optimize the MR imaging protocol for coronary arterial wall depiction in vitro and characterize the coronary atherosclerotic plaques. Materials and Methods MRI examination was prospectively performed in ten porcine hearts in order to optimize the MR imaging protocol. Various surface coils were used for coronary arterial wall imaging with the same parameters. Then, the image parameters were further optimized for high-resolution coronary wall imaging. The signal-noise ratio (SNR) and contrast-noise ratio (CNR) of images were measured. Finally, 8 human cadaver hearts with coronary atherosclerotic plaques were prospectively performed with MRI examination using optimized protocol in order to characterize the coronary atherosclerotic plaques. Results The SNR and CNR of MR image with temporomandibular coil were the highest of various surface coils. High-resolution and high SNR and CNR for ex vivo coronary artery wall depiction can be achieved using temporomandibular coil with 512 × 512 in matrix. Compared with histopathology, the sensitivity and specificity of MRI for identifying advanced plaques were: type IV-V (lipid, necrosis, fibrosis), 94% and 95%; type VI (hemorrhage), 100% and 98%; type VII (calcification), 91% and 100%; and type VIII (fibrosis without lipid core), 100% and 98%, respectively. Conclusion Temporomandibular coil appears to be dramatically superior to eight-channel head coil and knee coil for ex vivo coronary artery wall imaging, providing higher spatial resolution and improved the SNR. Ex vivo high-resolution MRI has capability to distinguish human coronary atherosclerotic plaque compositions and accurately classify advanced plaques.
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Affiliation(s)
- Jiong Yang
- Department of Medical, The General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China
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18
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Macedo R, Fernandes JL, Andrade SS, Rochitte CE, Lima KC, Maciel ACC, Maciel FC, Alves GSP, Coelho OR, Diniz RVZ. Morphological and functional measurements of the heart obtained by magnetic resonance imaging in Brazilians. Arq Bras Cardiol 2013; 101:68-77. [PMID: 23752338 PMCID: PMC3998183 DOI: 10.5935/abc.20130113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 12/16/2012] [Accepted: 03/20/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Still today, measurements used as a reference in the cardiac magnetic resonance imaging have been obtained mainly from studies carried out in North-American and European populations. OBJECTIVE To obtain measurements of the diastolic diameter, systolic diameter, end diastolic volume, end systolic volume, ejection fraction, and myocardial mass of the left and right ventricles in Brazilians. METHODS 54 men and 53 women, with mean age of 43.4 ± 13.1 years, asymptomatic, with no cardiomyopathies, have been subjected to the cardiac magnetic resonance imaging, using a balanced steady state free precession technique. RESULTS The averages and the standard deviations of the parameters for the left ventricle have been: diastolic diameter = 4.8 ± 0.5 cm; systolic diameter = 3.0 ± 0.6 cm; end diastolic volume = 128.4 ± 29.6 mL; end systolic volume = 45.2 ± 16.6 mL; ejection fraction = 65.5 ± 6.3%; mass = 95.2 ± 30.8 g. For the right ventricle, they have been: diastolic diameter = 3.9 ± 1.3 cm; systolic diameter = 2.5 ± 0.5 cm; end diastolic volume = 126.5 ± 30.7 mL; end systolic volume = 53.6 ± 18.4 mL; ejection fraction = 58.3 ± 8.0%, and mass = 26.1 ± 6.1 g. The masses and the volumes were significantly greater in the men, except for the end systolic volume of the left ventricle. The ejection fraction of the right ventricle has been significantly greater in the women. There has been a significant and inverted correlation of the systolic volume of the right volume with the progression of the age. CONCLUSION This study has described, for the first time, cardiac measurements obtained through the cardiac magnetic resonance imaging in Brazilians, asymptomatic, with no cardiomyopathies, showing differences in accordance with gender and age.
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Affiliation(s)
- Robson Macedo
- Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Petersen SE, Matthews PM, Bamberg F, Bluemke DA, Francis JM, Friedrich MG, Leeson P, Nagel E, Plein S, Rademakers FE, Young AA, Garratt S, Peakman T, Sellors J, Collins R, Neubauer S. Imaging in population science: cardiovascular magnetic resonance in 100,000 participants of UK Biobank - rationale, challenges and approaches. J Cardiovasc Magn Reson 2013; 15:46. [PMID: 23714095 PMCID: PMC3668194 DOI: 10.1186/1532-429x-15-46] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/16/2013] [Indexed: 01/22/2023] Open
Abstract
UK Biobank is a prospective cohort study with 500,000 participants aged 40 to 69. Recently an enhanced imaging study received funding. Cardiovascular magnetic resonance (CMR) will be part of a multi-organ, multi-modality imaging visit in 3-4 dedicated UK Biobank imaging centres that will acquire and store imaging data from 100,000 participants (subject to successful piloting). In each of UK Biobank's dedicated bespoke imaging centres, it is proposed that 15-20 participants will undergo a 2 to 3 hour visit per day, seven days a week over a period of 5-6 years. The imaging modalities will include brain MRI at 3 Tesla, CMR and abdominal MRI at 1.5 Tesla, carotid ultrasound and DEXA scans using carefully selected protocols. We reviewed the rationale, challenges and proposed approaches for concise phenotyping using CMR on such a large scale. Here, we discuss the benefits of this imaging study and review existing and planned population based cardiovascular imaging in prospective cohort studies. We will evaluate the CMR protocol, feasibility, process optimisation and costs. Procedures for incidental findings, quality control and data processing and analysis are also presented. As is the case for all other data in the UK Biobank resource, this database of images and related information will be made available through UK Biobank's Access Procedures to researchers (irrespective of their country of origin and whether they are academic or commercial) for health-related research that is in the public interest.
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Affiliation(s)
- Steffen E Petersen
- Centre Lead for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, The London Chest Hospital, Bonner Road, London E2 9JX, UK
| | - Paul M Matthews
- Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
- GlaxoSmithKline Research and Development, Ltd, Munich, Germany
| | - Fabian Bamberg
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany
| | - David A Bluemke
- Radiology and Imaging Sciences, NIH Clinical Center, Oxford, UK
| | - Jane M Francis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthias G Friedrich
- Montreal Heart Institute, Université de Montréal and University of Calgary, Calgary, Canada
| | - Paul Leeson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Eike Nagel
- King’s College London British Heart Foundation Centre of Excellence; National Institute of Health Research (NIHR) Biomedical Research Centre at Guy’s and St. Thomas’ (NHS)Foundation Trust; Wellcome Trust and Engineering and Physical Sciences Research Council (EPSRC) Medical Engineering Centre; Division of Imaging Sciences; The Rayne Institute, St. Thomas’ Hospital, London, UK
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds LS2 9JT, UK
| | | | - Alistair A Young
- Department of Anatomy with Radiology, University of Auckland, Auckland, UK
| | - Steve Garratt
- UK Biobank, Spectrum Way, Adswood, Stockport, Cheshire SK3 0SA, UK
| | - Tim Peakman
- UK Biobank, Spectrum Way, Adswood, Stockport, Cheshire SK3 0SA, UK
| | - Jonathan Sellors
- UK Biobank, Spectrum Way, Adswood, Stockport, Cheshire SK3 0SA, UK
| | - Rory Collins
- UK Biobank, Spectrum Way, Adswood, Stockport, Cheshire SK3 0SA, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Abd-Elmoniem KZ, Gharib AM, Pettigrew RI. Coronary vessel wall 3-T MR imaging with time-resolved acquisition of phase-sensitive dual inversion-recovery (TRAPD) technique: initial results in patients with risk factors for coronary artery disease. Radiology 2012; 265:715-23. [PMID: 23047838 DOI: 10.1148/radiol.12120068] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop a technique for time-resolved acquisition of phase-sensitive dual-inversion recovery (TRAPD) coronary vessel wall magnetic resonance (MR) images, to investigate the success rate in coronary wall imaging compared with that of single-frame imaging, and to assess vessel wall thickness in healthy subjects and subjects with risk factors for coronary artery disease (CAD). MATERIALS AND METHODS Thirty-eight subjects (12 healthy subjects, 26 subjects with at least one CAD risk factor) provided informed consent for participation in this institutional review board-approved and HIPAA-compliant study. The TRAPD coronary vessel wall imaging sequence was developed and validated with a flow phantom. Time-resolved coronary artery wall images at three to five cine phases were obtained in all subjects. Qualitative and quantitative comparisons were made between TRAPD and conventional single-image wall measurements. Measurement reproducibility also was assessed. Statistical analysis was performed for all comparisons. RESULTS The TRAPD sequence successfully restored the negative polarity of lumen signal and enhanced lumen wall contrast on the cine images of the flow phantom and in all subjects. Use of three to five frames increased the success rate of acquiring at least one image of good to excellent quality from 76% in single-image acquisitions to 95% with the TRAPD sequence. The difference in vessel wall thickness between healthy subjects and subjects with CAD risk factors was significant (P < .05) with the TRAPD sequence (1.07 vs 1.46 mm, respectively; 36% increase) compared with single-frame dual inversion-recovery imaging (1.24 vs 1.55 mm, respectively; 25% increase). Intraobserver, interobserver, and interexamination agreement for wall thickness measurement were 0.98, 0.97, and 0.92, respectively. CONCLUSION TRAPD imaging of coronary arteries improved arterial wall visualization and quantitative assessment by increasing the success rate of obtaining good- to excellent-quality images and sections orthogonal to the longitudinal axis of the vessel. This also resulted in vessel wall thickness measurements that show a more distinct difference between healthy subjects and those with CAD risk factors. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120068/-/DC1.
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Affiliation(s)
- Khaled Z Abd-Elmoniem
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr, Bldg 10, Room 3-5340, Bethesda, MD 20892, USA.
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Classification of Human Coronary Atherosclerotic Plaques Using Ex Vivo High-Resolution Multicontrast-Weighted MRI Compared With Histopathology. AJR Am J Roentgenol 2012; 198:1069-75. [PMID: 22528895 DOI: 10.2214/ajr.11.6496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Does heart rate influence CMR image quality of the coronary vessel wall? Int J Cardiovasc Imaging 2012; 28:563-5. [PMID: 21594649 PMCID: PMC3326365 DOI: 10.1007/s10554-011-9884-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 05/03/2011] [Indexed: 10/28/2022]
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Abstract
'Multimodality' imaging--the side-by-side interpretation of data obtained from various noninvasive imaging techniques, such as echocardiography, radionuclide techniques, multidetector CT (MDCT), and MRI--allows anatomical, morphological, and functional data to be combined, increases diagnostic accuracy, and improves the efficacy of cardiovascular interventions and clinical outcomes. During the past decade, advances in software and hardware have allowed co-registration of various imaging modalities, resulting in cardiac 'hybrid' or 'fusion' imaging. In this Review, we discuss the roles of both multimodality and hybrid imaging in three broad areas of cardiology--coronary artery disease (CAD), heart failure, and valvular heart disease. In the evaluation of CAD, integration of either single-photon emission computed tomography (SPECT) or PET with CT coronary angiography provides both morphological and functional data in a single procedure. Accordingly, the functional consequences (myocardial hypoperfusion on SPECT or PET) of anatomical pathology (coronary anatomy on MDCT or MRI) can be assessed. Co-registration of PET and MRI data sets to provide cellular and molecular information on plaque composition and stability is now possible. Furthermore, novel imaging modalities have been implemented to guide electrophysiological and transcatheter-based procedures, such as cardiac resynchronization therapy (an established treatment for patients with heart failure), and transcatheter valve repair or replacement procedures.
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Yang E, Vargas JD, Bluemke DA. Understanding the genetics of coronary artery disease through the lens of noninvasive imaging. Expert Rev Cardiovasc Ther 2012; 10:27-36. [PMID: 22149524 PMCID: PMC3482161 DOI: 10.1586/erc.11.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronary artery disease is a common condition with a known heritable component that has spurred interest in genetic research for decades, resulting in a handful of candidate genes and an appreciation for the complexity of its genetic contributions. Recent advances in sequencing technologies have resulted in large-scale association studies, possibly adding to our current understanding of the genetics of coronary artery disease. Sifting through the statistical noise, however, requires the selection of effective phenotypic markers. New imaging technologies have improved our ability to detect subclinical atherosclerosis in a safe and reproducible manner in large numbers of patients. In this article, we propose that advances in imaging technology have generated improved phenotypic markers for genetic association studies of coronary artery disease.
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Affiliation(s)
| | - Jose D Vargas
- Radiology and Imaging Sciences, National Institutes of Health
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Dr, Rm 10/1C355, Bethesda, MD, 20892
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He Y, Zhang Z, Dai Q, Zhou Y, Yang Y, Yu W, An J, Jin L, Jerecic R, Yuan C, Li D. Accuracy of MRI to identify the coronary artery plaque: a comparative study with intravascular ultrasound. J Magn Reson Imaging 2011; 35:72-8. [PMID: 21989946 DOI: 10.1002/jmri.22652] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the ability of black-blood coronary arterial wall MRI to identify the coronary artery plaque, using intravascular ultrasound (IVUS) as the golden standard. MATERIALS AND METHODS Nineteen consecutive patients underwent IVUS and coronary artery wall MRI. Cross-sectional images were acquired on the lesion of coronary artery from the ostium to the middle segment continuously. The vessel cross-sectional area (CSA), luminal CSA, plaque burden, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured in each slice which was then compared with the IVUS images. RESULTS Sixteen of 19 patients completed coronary artery MRA and wall imaging. 41 of 67 slices were found plaques on both IVUS and MRI; The maximal wall thickness, plaque burden, SNR, CNR in the coronary wall containing plaque were greater compared with the normal coronary wall (1.70 ± 0.51 versus 1.24 ± 0.24; 0.71 ± 0.13 versus 0.59 ± 0.12; 1.86 ± 0.41 versus 1.47 ± 0.23; 5.10 ± 2.21 versus 2.99 ± 1.17; respectively, P < 0.05). The matched MRI and IVUS showed good correlation for vessel CSA (16.77 ± 10.67 versus 16.97 ± 8.36; r = 0.79; P < 0.01), luminal CSA (5.18 ± 5.01 versus 7.13 ± 5.14; r = 0.88; P < 0.01), plaque burden (0.71 ± 0.13 versus 0.59 ± 0.15; r = 0.67; P < 0.01). in segments containing plaques, especially the luminal CSA were strongly correlated. CONCLUSION MRI coronary artery wall imaging can identify coronary plaque in the proximal segments. It also has the potential to assess coronary artery size.
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Affiliation(s)
- Yi He
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
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Li T, Zhao X, Liu X, Gao J, Zhao S, Li X, Zhou W, Cai Z, Zhang W, Yang L. Evaluation of the early enhancement of coronary atherosclerotic plaque by contrast-enhanced MR angiography. Eur J Radiol 2011; 80:136-42. [DOI: 10.1016/j.ejrad.2010.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Revised: 07/14/2010] [Accepted: 07/19/2010] [Indexed: 10/19/2022]
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Miao C, Chen S, Ding J, Liu K, Li D, Macedo R, Lai S, Vogel-Claussen J, Brown ER, Lima JAC, Bluemke DA. The association of pericardial fat with coronary artery plaque index at MR imaging: The Multi-Ethnic Study of Atherosclerosis (MESA). Radiology 2011; 261:109-15. [PMID: 21846753 DOI: 10.1148/radiol.11110346] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population-based cohort. MATERIALS AND METHODS In this institutional review board-approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included. The coronary artery eccentricity (ratio of maximal to minimal coronary artery wall thickness) was determined by using magnetic resonance (MR) imaging and served as an index of plaque burden. The pericardial fat volume was determined by using computed tomography. Linear regression coefficient analysis was used to correlate pericardial fat volume with coronary artery wall thickness and plaque eccentricity. RESULTS Pericardial fat volume correlated significantly with degree of plaque eccentricity (P < .05) in both men and women. After adjustments for body mass index (BMI) and waist circumference, traditional risk factors, C-reactive protein level, and coronary artery calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men (P < .01) but not in women. BMI and waist circumference correlated with degree of plaque eccentricity in the univariate model (P < .05) but not after adjustment for pericardial fat volume or traditional risk factors. CONCLUSION Pericardial fat volume, rather than BMI and waist circumference, was more strongly related to plaque eccentricity as a measure of coronary atherosclerotic plaque burden. The results support the proposed role of pericardial fat in association with atherosclerosis.
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Affiliation(s)
- Cuilian Miao
- Department of Radiology, Northwestern University Medical School, Chicago, IL, USA
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Scott AD, Keegan J, Mohiaddin RH, Firmin DN. Noninvasive detection of coronary artery wall thickening with age in healthy subjects using high resolution MRI with beat-to-beat respiratory motion correction. J Magn Reson Imaging 2011; 34:824-30. [PMID: 21800396 DOI: 10.1002/jmri.22704] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 06/02/2011] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To demonstrate coronary artery wall thickening with age in a small healthy cohort using a highly efficient, reliable, and reproducible high-resolution MR technique. MATERIALS AND METHODS A 3D cross-sectional MR vessel wall images (0.7 × 0.7 × 3 mm resolution) with retrospective beat-to-beat respiratory motion correction (B2B-RMC) were obtained in the proximal right coronary artery of 21 healthy subjects (age, 22-62 years) with no known cardiovascular disease. Lumen and outer wall (lumen + vessel wall) areas were measured in one central slice from each subject and average wall thickness and wall area/outer wall area ratio (W/OW) calculated. RESULTS Imaging was successful in 18 (86%) subjects with average respiratory efficiency 99.3 ± 1.7%. Coronary vessel wall thickness and W/OW significantly correlate with subject age, increasing by 0.088 mm and 0.031 per decade respectively (R = 0.53, P = 0.024 and R = 0.48, P = 0.046). No relationship was found between lumen area and vessel wall thickness (P = NS), but outer wall area increased significantly with vessel wall thickness at 19 mm(2) per mm (P = 0.046). This is consistent with outward vessel wall remodeling. CONCLUSION Despite the small size of our healthy cohort, using high-resolution MR imaging and B2B-RMC, we have demonstrated increasing coronary vessel wall thickness and W/OW with age. The results obtained are consistent with outward vessel wall remodeling.
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Affiliation(s)
- Andrew D Scott
- Cardiovascular Magnetic Resonance Unit, National Heart and Lung Institute, Imperial College London, Sydney Street, London, UK.
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Terashima M, Nguyen PK, Rubin GD, Meyer CH, Shimakawa A, Nishimura DG, Ehara S, Iribarren C, Courtney BK, Go AS, Hlatky MA, Fortmann SP, McConnell MV. Right coronary wall CMR in the older asymptomatic advance cohort: positive remodeling and associations with type 2 diabetes and coronary calcium. J Cardiovasc Magn Reson 2010; 12:75. [PMID: 21192815 PMCID: PMC3022803 DOI: 10.1186/1532-429x-12-75] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 12/30/2010] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Coronary wall cardiovascular magnetic resonance (CMR) is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort. RESULTS Cross-sectional images of the proximal right coronary artery (RCA) were acquired using spiral black-blood coronary CMR (0.7 mm resolution) in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female). Coronary measurements (total vessel area, lumen area, wall area, and wall thickness) had small intra- and inter-observer variabilities (r = 0.93~0.99, all p < 0.0001), though one-third of these older subjects had suboptimal image quality. Increased coronary wall thickness correlated with increased coronary vessel area (p < 0.0001), consistent with positive remodeling. On multivariate analysis, type 2 diabetes was the only risk factor associated with increased coronary wall area and thickness (p = 0.03 and p = 0.007, respectively). Coronary wall CMR measures were also associated with coronary calcification (p = 0.01-0.03). CONCLUSIONS Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.
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Affiliation(s)
- Masahiro Terashima
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Patricia K Nguyen
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Geoffrey D Rubin
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Craig H Meyer
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Ann Shimakawa
- Applied Science Laboratory-West, GE Healthcare, Menlo Park, CA, USA
| | - Dwight G Nishimura
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University School of Medicine, Stanford, CA, USA
| | - Shoichi Ehara
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Carlos Iribarren
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA
| | - Brian K Courtney
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Alan S Go
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA
- Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Mark A Hlatky
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Stephen P Fortmann
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael V McConnell
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University School of Medicine, Stanford, CA, USA
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Scott AD, Keegan J, Firmin DN. High-resolution 3D coronary vessel wall imaging with near 100% respiratory efficiency using epicardial fat tracking: Reproducibility and comparison with standard methods. J Magn Reson Imaging 2010; 33:77-86. [DOI: 10.1002/jmri.22398] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Abstract
Vessel wall imaging of large vessels has the potential to identify culprit atherosclerotic plaques that lead to cardiovascular events. Comprehensive assessment of atherosclerotic plaque size, composition, and biological activity is possible with magnetic resonance imaging (MRI). Magnetic resonance imaging of the atherosclerotic plaque has demonstrated high accuracy and measurement reproducibility for plaque size. The accuracy of in vivo multicontrast MRI for identification of plaque composition has been validated against histological findings. Magnetic resonance imaging markers of plaque biological activity such as neovasculature and inflammation have been demonstrated. In contrast to other plaque imaging modalities, MRI can be used to study multiple vascular beds noninvasively over time. In this review, we compare the status of in vivo plaque imaging by MRI to competing imaging modalities. Recent MR technological improvements allow fast, accurate, and reproducible plaque imaging. An overview of current MRI techniques required for carotid plaque imaging including hardware, specialized pulse sequences, and processing algorithms are presented. In addition, the application of these techniques to coronary, aortic, and peripheral vascular beds is reviewed.
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Abstract
Cardiovascular disease is the leading course of death and disability. Conventional cardiac risk factors do not fully explain the level of cardiovascular risk, incidence of coronary artery disease, and coronary events. Risk stratification and therapy based solely on these conventional risk factors may overlook a population who would benefit from lifestyle and risk factor modification. Thus, research has recently focused on improving risk assessment with new tools in an effort to better identify subjects at highest risk and in need of aggressive management. Cardiovascular imaging, both in coronary and extracoronary arterial beds, has proven to be very helpful in this regard. In this article, we review the current literature from multicenter epidemiology studies on the utility of noninvasive imaging modalities for risk stratification in the context of conventional risk factor evaluation.
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Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Current clinical techniques that rely on stenosis measurement alone appear to be insufficient for risk prediction in atherosclerosis patients. Many novel imaging methods have been developed to study atherosclerosis progression and to identify new features that can predict future clinical risk. MRI of atherosclerotic vessel walls is one such method. It has the ability to noninvasively evaluate multiple biomarkers of the disease such as luminal stenosis, plaque burden, tissue composition and plaque activity. In addition, the accuracy of in vivo MRI has been validated against histology with high reproducibility, thus paving the way for application to epidemiological studies of disease pathogenesis and, by serial MRI, in monitoring the efficacy of therapeutic intervention. In this review, we describe the various MR techniques used to evaluate aspects of plaque progression, discuss imaging-based measurements (imaging biomarkers), and also detail their validation. The application of plaque MRI in clinical trials as well as emerging imaging techniques used to evaluate plaque compositional features and biological activities are also discussed.
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Affiliation(s)
- Jinnan Wang
- Clinical Sites Research Program, Philips Research North America, Briarcliff Manor, NY, 10510
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Niranjan Balu
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Gador Canton
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, 98109
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Li D, Fayad ZA, Bluemke DA. Can contrast-enhanced cardiac magnetic resonance assess inflammation of the coronary wall? JACC Cardiovasc Imaging 2009; 2:589-91. [PMID: 19442945 DOI: 10.1016/j.jcmg.2009.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Accepted: 03/18/2009] [Indexed: 10/20/2022]
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Sibley CT, Bluemke DA. Will 3.0-T make coronary magnetic resonance angiography competitive with computed tomography angiography? J Am Coll Cardiol 2009; 54:77-8. [PMID: 19555844 DOI: 10.1016/j.jacc.2009.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 04/21/2009] [Indexed: 11/30/2022]
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Miao C, Chen S, Macedo R, Lai S, Liu K, Li D, Wasserman BA, Vogel-Claussen J, Vogel-Clausen J, Lima JAC, Bluemke DA. Positive remodeling of the coronary arteries detected by magnetic resonance imaging in an asymptomatic population: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 2009; 53:1708-15. [PMID: 19406347 DOI: 10.1016/j.jacc.2008.12.063] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2008] [Revised: 12/11/2008] [Accepted: 12/22/2008] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to assess coronary arterial remodeling as a marker of subclinical atherosclerosis using coronary wall magnetic resonance imaging (MRI) in an asymptomatic population-based cohort. BACKGROUND In early atherosclerosis, compensatory enlargement of both the outer wall of the vessel as well as the lumen, termed compensatory enlargement or positive remodeling, occurs before luminal narrowing. METHODS One hundred seventy-nine participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial were evaluated using black-blood coronary wall MRI. Coronary cross-sectional area (vessel size), lumen area, and mean wall thickness of the proximal coronary arteries were measured. RESULTS Men had a greater vessel size, lumen area, and mean wall thickness than women (38.3 +/- 11.3 mm2 vs. 32.6 +/- 9.4 mm2, 6.7 +/- 3.2 mm2 vs. 5.3 +/- 2.4 mm2, and 2.0 +/- 0.3 mm vs. 1.9 +/- 0.3 mm, respectively, p < 0.05). No significant coronary artery narrowing was present by magnetic resonance angiography. Overall, coronary vessel size increased 25.9 mm2 per millimeter increase in coronary wall thickness, whereas lumen area increased only slightly at 3.1 mm2 for every millimeter increase in wall thickness (difference in slopes, p < 0.0001). Adjusting for age and sex, participants with an Agatston score >0 were more likely to have wall thickness >2.0 mm (odds ratio: 2.0, 95% confidence interval: 1.01 to 3.84). CONCLUSIONS Coronary wall MRI detected positive arterial remodeling in asymptomatic men and women with subclinical atherosclerosis.
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Affiliation(s)
- Cuilian Miao
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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