Doris Mhairi K, Dweck Marc R, Fayad Zahi A
aCentre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK bTranslational and Molecular Imaging Institute cZena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Curr Opin Lipidol. 2016 Dec;27(6):605-614. doi: 10.1097/MOL.0000000000000350.
As our understanding of cardiovascular disease has advanced over the past decades, multiple novel treatment strategies have been developed with the hope of reducing the global morbidity and mortality associated with this condition. Large-scale trials to test such novel therapies using clinical end points are expensive, leading to interest in phase II clinical trials with imaging-derived outcome measures.
Noninvasive imaging techniques that assess changes in both atherosclerotic disease burden and plaque composition in response to therapy are well established. With the advent of molecular techniques and hybrid imaging, we now have the ability to assess disease activity alongside these standard anatomic assessments. This multifaceted approach has the potential to provide a more comprehensive assessment of the actions and efficacy of novel therapies in the carotids, aorta and coronary arteries.
This review will examine how advanced noninvasive imaging strategies have been used to investigate drug efficacy in intervention trials to date, and crucially how these approaches are set to evolve and play a central role in developing the next generation of atherosclerotic medication.
在过去几十年里，随着我们对心血管疾病认识的不断深入，已开发出多种新型治疗策略，以期降低与此疾病相关的全球发病率和死亡率。使用临床终点来测试此类新型疗法的大规模试验成本高昂，这引发了人们对采用影像学衍生结局指标的II期临床试验的兴趣。
评估动脉粥样硬化疾病负担和斑块成分在治疗后变化的非侵入性成像技术已相当成熟。随着分子技术和混合成像技术的出现，我们现在有能力在这些标准解剖学评估的同时评估疾病活动。这种多方面的方法有可能对新型疗法在颈动脉、主动脉和冠状动脉中的作用及疗效提供更全面的评估。
本综述将探讨迄今为止先进的非侵入性成像策略如何用于干预试验中研究药物疗效，以及至关重要的是，这些方法将如何发展并在开发下一代动脉粥样硬化药物中发挥核心作用。
