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Jagadeesan K, Palanisamy G. Atherosclerosis plaque tissue classification using self-attention-based conditional variational auto-encoder generative adversarial network using OCT plaque image. BIOMED ENG-BIOMED TE 2023; 68:633-649. [PMID: 37401612 DOI: 10.1515/bmt-2022-0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 05/08/2023] [Indexed: 07/05/2023]
Abstract
Adults with coronary artery disease often have atherosclerosis, this is defined as the accumulation of plaque in the tissues of the arterial wall. Cardiologists utilize optical coherence tomography (OCT), a light-based imaging method, to examine the layers of intracoronary tissue along pathological formations, such as plaque accumulation. Intracoronary cross-sectional images produced by state-of-the-art catheter-based imaging scheme have 10-15 µm high resolution. Nevertheless, interpretation of the obtained images depends on the operator, which takes a lot of time and is exceedingly error-prone from one observer to another. OCT image post-processing that automatically and accurately tags coronary plaques can help the technique become more widely used and lower the diagnostic error rate. To overcome these problems, Atherosclerosis plaque tissue classification using Self-Attention-Based Conditional Variational Auto-Encoder Generative Adversarial Network (APC-OCTPI-SACVAGAN) is proposed which classifies the Atherosclerosis plaque images as Fibro calcific plaque, Fibro atheroma, Thrombus, Fibrous plaque and Micro-vessel. The proposed APC-OCTPI-SACVAGAN technique is executed in MATLAB. The efficiency of proposed APC-OCTPI-SACVAGAN method attains 16.19 %, 17.93 %, 19.81 % and 1.57 % higher accuracy; 16.92 %, 11.54 %, 5.29 % and 1.946 % higher Area under curve; and 28.06 %, 25.32 %, 32.19 % and 39.185 % lower computational time comparing to the existing methods respectively.
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Affiliation(s)
- Kowsalyadevi Jagadeesan
- Research Scholar, Department of Computer Science and Engineering, College of Engineering Guindy, Anna University, Chennai, Tamil Nadu, India
| | - Geetha Palanisamy
- Department of Computer Science and Engineering, College of Engineering Guindy, Anna University, Chennai, Tamil Nadu, India
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2
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Nafee T, Shah A, Forsberg M, Zheng J, Ou J. State-of-art review: intravascular imaging in percutaneous coronary interventions. CARDIOLOGY PLUS 2023; 8:227-246. [PMID: 38304487 PMCID: PMC10829907 DOI: 10.1097/cp9.0000000000000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024] Open
Abstract
The history of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) reflects the relentless pursuit of innovation in interventional cardiology. These intravascular imaging technologies have played a pivotal role in our understanding of coronary atherosclerosis, vascular pathology, and the interaction of coronary stents with the vessel wall. Two decades of clinical investigations demonstrating the clinical efficacy and safety of intravascular imaging modalities have established these technologies as staples in the contemporary cardiac catheterization lab's toolbox and earning their place in revascularization clinical practice guidelines. In this comprehensive review, we will delve into the historical evolution, mechanisms, and technical aspects of IVUS and OCT. We will discuss the expanding evidence supporting their use in complex percutaneous coronary interventions, emphasizing their crucial roles in optimizing patient outcomes and ensuring procedural success. Furthermore, we will explore the substantial advances that have propelled these imaging modalities to the forefront of contemporary interventional cardiology. Finally, we will survey the latest developments in the field and explore the promising future directions that have the potential to further revolutionize coronary interventions.
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Affiliation(s)
- Tarek Nafee
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Areeb Shah
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Michael Forsberg
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Jingsheng Zheng
- Department of Cardiology, AtlantiCare Regional Medical Center, Pomona, NJ 08240, USA
| | - Jiafu Ou
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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3
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Gurgoglione FL, Denegri A, Russo M, Calvieri C, Benatti G, Niccoli G. Intracoronary Imaging of Coronary Atherosclerotic Plaque: From Assessment of Pathophysiological Mechanisms to Therapeutic Implication. Int J Mol Sci 2023; 24:ijms24065155. [PMID: 36982230 PMCID: PMC10049285 DOI: 10.3390/ijms24065155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 03/10/2023] Open
Abstract
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.
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Affiliation(s)
| | - Andrea Denegri
- Cardiology Department, Azienda Ospedaliero-Universitaria of Parma, 43126 Parma, Italy
| | - Michele Russo
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, 31015 Conegliano, Italy
| | - Camilla Calvieri
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University, 00185 Rome, Italy
| | - Giorgio Benatti
- Cardiology Department, Azienda Ospedaliero-Universitaria of Parma, 43126 Parma, Italy
| | - Giampaolo Niccoli
- Cardiology Department, University of Parma, 43126 Parma, Italy
- Cardiology Department, Azienda Ospedaliero-Universitaria of Parma, 43126 Parma, Italy
- Correspondence: ; Tel.: +39-0521-702070; Fax: +39-0521-702189
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4
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Ultrasonic Imaging of Cardiovascular Disease Based on Image Processor Analysis of Hard Plaque Characteristics. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4304524. [PMID: 36277887 PMCID: PMC9584660 DOI: 10.1155/2022/4304524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease detection and analysis using ultrasonic imaging expels errors in manual clinical trials with precise outcomes. It requires a combination of smart computing systems and intelligent image processors. The disease characteristics are analyzed based on the configuration and precise tuning of the processing device. In this article, a characteristic extraction technique (CET) using knowledge learning (KL) is introduced to improve the analysis precision. The proposed method requires optimal selection of disease features and trained similar datasets for improving the characteristic extraction. The disease attributes and accuracy are identified using the standard knowledge update. The image and data features are segmented using the variable processor configuration to prevent false rates. The false rates due to unidentifiable plaque characteristics result in weak knowledge updates. Therefore, the segmentation and data extraction are unanimously performed to prevent feature misleads. The knowledge base is updated using the extracted and identified plaque characteristics for consecutive image analysis. The processor configurations are manageable using the updated knowledge and characteristics to improve precision. The proposed method is verified using precision, characteristic update, training rate, extraction ratio, and time factor.
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Baruś P, Modrzewski J, Gumiężna K, Dunaj P, Głód M, Bednarek A, Wańha W, Roleder T, Kochman J, Tomaniak M. Comparative Appraisal of Intravascular Ultrasound and Optical Coherence Tomography in Invasive Coronary Imaging: 2022 Update. J Clin Med 2022; 11:jcm11144055. [PMID: 35887819 PMCID: PMC9324054 DOI: 10.3390/jcm11144055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023] Open
Abstract
Although coronary angiography has been well established as a standard modality for percutaneous coronary intervention guidance, recent developments in intravascular imaging techniques, such as intravascular ultrasound and optical coherence tomography, have become increasingly adopted, enabling direct detailed lesion visualization, including lesions beyond the scope of assessment using exclusively angiography. Intravascular imaging modalities have been reported to potentially improve both short- and long-term percutaneous intervention outcomes. This review aims to provide a comparative summary of recent advancements in research regarding the clinical applications and outcomes of intravascular ultrasound and optical coherence tomography.
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Affiliation(s)
- Piotr Baruś
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Jakub Modrzewski
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Karolina Gumiężna
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Piotr Dunaj
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Marcin Głód
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Adrian Bednarek
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Tomasz Roleder
- Department of Cardiology, Regional Specialist Hospital in Wrocław, 51-124 Wroclaw, Poland;
| | - Janusz Kochman
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
| | - Mariusz Tomaniak
- First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.B.); (J.M.); (K.G.); (P.D.); (M.G.); (A.B.); (J.K.)
- Correspondence: ; Tel.: +48-599-19-51
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6
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Carpenter HJ, Ghayesh MH, Zander AC, Li J, Di Giovanni G, Psaltis PJ. Automated Coronary Optical Coherence Tomography Feature Extraction with Application to Three-Dimensional Reconstruction. Tomography 2022; 8:1307-1349. [PMID: 35645394 PMCID: PMC9149962 DOI: 10.3390/tomography8030108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022] Open
Abstract
Coronary optical coherence tomography (OCT) is an intravascular, near-infrared light-based imaging modality capable of reaching axial resolutions of 10–20 µm. This resolution allows for accurate determination of high-risk plaque features, such as thin cap fibroatheroma; however, visualization of morphological features alone still provides unreliable positive predictive capability for plaque progression or future major adverse cardiovascular events (MACE). Biomechanical simulation could assist in this prediction, but this requires extracting morphological features from intravascular imaging to construct accurate three-dimensional (3D) simulations of patients’ arteries. Extracting these features is a laborious process, often carried out manually by trained experts. To address this challenge, numerous techniques have emerged to automate these processes while simultaneously overcoming difficulties associated with OCT imaging, such as its limited penetration depth. This systematic review summarizes advances in automated segmentation techniques from the past five years (2016–2021) with a focus on their application to the 3D reconstruction of vessels and their subsequent simulation. We discuss four categories based on the feature being processed, namely: coronary lumen; artery layers; plaque characteristics and subtypes; and stents. Areas for future innovation are also discussed as well as their potential for future translation.
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Affiliation(s)
- Harry J. Carpenter
- School of Mechanical Engineering, University of Adelaide, Adelaide, SA 5005, Australia;
- Correspondence: (H.J.C.); (M.H.G.)
| | - Mergen H. Ghayesh
- School of Mechanical Engineering, University of Adelaide, Adelaide, SA 5005, Australia;
- Correspondence: (H.J.C.); (M.H.G.)
| | - Anthony C. Zander
- School of Mechanical Engineering, University of Adelaide, Adelaide, SA 5005, Australia;
| | - Jiawen Li
- School of Electrical Electronic Engineering, University of Adelaide, Adelaide, SA 5005, Australia;
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, SA 5005, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, SA 5005, Australia
| | - Giuseppe Di Giovanni
- Vascular Research Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (G.D.G.); (P.J.P.)
| | - Peter J. Psaltis
- Vascular Research Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (G.D.G.); (P.J.P.)
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
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7
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Kadry K, Olender ML, Marlevi D, Edelman ER, Nezami FR. A platform for high-fidelity patient-specific structural modelling of atherosclerotic arteries: from intravascular imaging to three-dimensional stress distributions. J R Soc Interface 2021; 18:20210436. [PMID: 34583562 DOI: 10.1098/rsif.2021.0436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The pathophysiology of atherosclerotic lesions, including plaque rupture triggered by mechanical failure of the vessel wall, depends directly on the plaque morphology-modulated mechanical response. The complex interplay between lesion morphology and structural behaviour can be studied with high-fidelity computational modelling. However, construction of three-dimensional (3D) and heterogeneous models is challenging, with most previous work focusing on two-dimensional geometries or on single-material lesion compositions. Addressing these limitations, we here present a semi-automatic computational platform, leveraging clinical optical coherence tomography images to effectively reconstruct a 3D patient-specific multi-material model of atherosclerotic plaques, for which the mechanical response is obtained by structural finite-element simulations. To demonstrate the importance of including multi-material plaque components when recovering the mechanical response, a computational case study was conducted in which systematic variation of the intraplaque lipid and calcium was performed. The study demonstrated that the inclusion of various tissue components greatly affected the lesion mechanical response, illustrating the importance of multi-material formulations. This platform accordingly provides a viable foundation for studying how plaque micro-morphology affects plaque mechanical response, allowing for patient-specific assessments and extension into clinically relevant patient cohorts.
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Affiliation(s)
- Karim Kadry
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Laboratory of Hemodynamics and Cardiovascular Technology, Swiss Federal Institute of Technology, MED 3.2922, 1015 Lausanne, Switzerland
| | - Max L Olender
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - David Marlevi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elazer R Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Farhad R Nezami
- Thoracic and Cardiac Surgery Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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8
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Lv R, Maehara A, Matsumura M, Wang L, Zhang C, Huang M, Guo X, Samady H, Giddens DP, Zheng J, Mintz GS, Tang D. Using Optical Coherence Tomography and Intravascular Ultrasound Imaging to Quantify Coronary Plaque Cap Stress/Strain and Progression: A Follow-Up Study Using 3D Thin-Layer Models. Front Bioeng Biotechnol 2021; 9:713525. [PMID: 34497800 PMCID: PMC8419245 DOI: 10.3389/fbioe.2021.713525] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Accurate plaque cap thickness quantification and cap stress/strain calculations are of fundamental importance for vulnerable plaque research. To overcome uncertainties due to intravascular ultrasound (IVUS) resolution limitation, IVUS and optical coherence tomography (OCT) coronary plaque image data were combined together to obtain accurate and reliable cap thickness data, stress/strain calculations, and reliable plaque progression predictions. IVUS, OCT, and angiography baseline and follow-up data were collected from nine patients (mean age: 69; m: 5) at Cardiovascular Research Foundation with informed consent obtained. IVUS and OCT slices were coregistered and merged to form IVUS + OCT (IO) slices. A total of 114 matched slices (IVUS and OCT, baseline and follow-up) were obtained, and 3D thin-layer models were constructed to obtain stress and strain values. A generalized linear mixed model (GLMM) and least squares support vector machine (LSSVM) method were used to predict cap thickness change using nine morphological and mechanical risk factors. Prediction accuracies by all combinations (511) of those predictors with both IVUS and IO data were compared to identify optimal predictor(s) with their best accuracies. For the nine patients, the average of minimum cap thickness from IVUS was 0.17 mm, which was 26.08% lower than that from IO data (average = 0.23 mm). Patient variations of the individual errors ranged from ‒58.11 to 20.37%. For maximum cap stress between IO and IVUS, patient variations of the individual errors ranged from ‒30.40 to 46.17%. Patient variations of the individual errors of maximum cap strain values ranged from ‒19.90 to 17.65%. For the GLMM method, the optimal combination predictor using IO data had AUC (area under the ROC curve) = 0.926 and highest accuracy = 90.8%, vs. AUC = 0.783 and accuracy = 74.6% using IVUS data. For the LSSVM method, the best combination predictor using IO data had AUC = 0.838 and accuracy = 75.7%, vs. AUC = 0.780 and accuracy = 69.6% using IVUS data. This preliminary study demonstrated improved plaque cap progression prediction accuracy using accurate cap thickness data from IO slices and the differences in cap thickness, stress/strain values, and prediction results between IVUS and IO data. Large-scale studies are needed to verify our findings.
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Affiliation(s)
- Rui Lv
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Akiko Maehara
- The Cardiovascular Research Foundation, Columbia University, New York, NY, United States
| | - Mitsuaki Matsumura
- The Cardiovascular Research Foundation, Columbia University, New York, NY, United States
| | - Liang Wang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Caining Zhang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Mengde Huang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Xiaoya Guo
- School of Science, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Habib Samady
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Don. P. Giddens
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, United States
| | - Gary S. Mintz
- The Cardiovascular Research Foundation, Columbia University, New York, NY, United States
| | - Dalin Tang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA, United States
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Circulating Biomarkers Reflecting Destabilization Mechanisms of Coronary Artery Plaques: Are We Looking for the Impossible? Biomolecules 2021; 11:biom11060881. [PMID: 34198543 PMCID: PMC8231770 DOI: 10.3390/biom11060881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022] Open
Abstract
Despite significant strides to mitigate the complications of acute coronary syndrome (ACS), this clinical entity still represents a major global health burden. It has so far been well-established that most of the plaques leading to ACS are not a result of gradual narrowing of the vessel lumen, but rather a result of sudden disruption of vulnerable atherosclerotic plaques. As most of the developed imaging modalities for vulnerable plaque detection are invasive, multiple biomarkers were proposed to identify their presence. Owing to the pivotal role of lipids and inflammation in the pathophysiology of atherosclerosis, most of the biomarkers originated from one of those processes, whereas recent advancements in molecular sciences shed light on the use of microRNAs. Yet, at present there are no clinically implemented biomarkers or any other method for that matter that could non-invasively, yet reliably, diagnose the vulnerable plaque. Hence, in this review we summarized the available knowledge regarding the pathophysiology of plaque instability, the current evidence on potential biomarkers associated with plaque destabilization and finally, we discussed if search for biomarkers could one day bring us to non-invasive, cost-effective, yet valid way of diagnosing the vulnerable, rupture-prone coronary artery plaques.
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