Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
J Cardiovasc Med (Hagerstown). 2012 Oct;13(10):635-9. doi: 10.2459/JCM.0b013e3283590cd2.
Atherosclerotic disease results in major clinical events and remains a leading cause of morbidity and mortality in the western World. Atherosclerotic plaques have a heterogeneous presentation. Atherosclerotic plaques with a vulnerable phenotype have been associated with an increased risk for cardiovascular complications. Intraplaque neovascularization and hemorrhage are histopathological features that have been linked with the vulnerable plaque. The role of intraplaque neovascularization and hemorrhage in plaque destabilization and lesion progression has gained serious interest. Intraplaque neovascularization and hemorrhage have been correlated with the occurrence of prior cardiovascular events and have predictive value for the occurrence of future cardiovascular events. Pharmacological interventions showed an inhibiting effect of lipid-lowering drugs on plaque neovascularization. Imaging modalities such as contrast-enhanced ultrasound or MRI are able to visualize intraplaque neovascularization and hemorrhage noninvasively. Consequently, detection of intraplaque neovascularization and hemorrhage visualized with noninvasive imaging might improve the stratification of 'high-risk' patients.
动脉粥样硬化疾病导致主要临床事件发生，仍是西方世界发病率和死亡率的主要原因。动脉粥样硬化斑块表现具有异质性。具有易损表型的动脉粥样硬化斑块与心血管并发症风险增加相关。斑块内新生血管形成和出血是与易损斑块相关的组织病理学特征。斑块内新生血管形成和出血在斑块不稳定和病变进展中的作用引起了人们的极大兴趣。斑块内新生血管形成和出血与先前心血管事件的发生相关，并对未来心血管事件的发生具有预测价值。药物干预显示降脂药物对斑块新生血管形成具有抑制作用。超声造影或 MRI 等成像方式能够无创地可视化斑块内新生血管形成和出血。因此，通过无创成像检测到的斑块内新生血管形成和出血可能会改善“高危”患者的分层。
