Pharmstandard Ventures, 123112 Moscow, Russia.
Department of Basic Research, Institute for Atherosclerosis Research, Skolkovo Innovative Center, 121609 Moscow, Russia.
Int J Mol Sci. 2020 Apr 23;21(8):2992. doi: 10.3390/ijms21082992.
Atherosclerosis is a lipoprotein-driven inflammatory disorder leading to a plaque formation at specific sites of the arterial tree. After decades of slow progression, atherosclerotic plaque rupture and formation of thrombi are the major factors responsible for the development of acute coronary syndromes (ACSs). In this regard, the detection of high-risk (vulnerable) plaques is an ultimate goal in the management of atherosclerosis and cardiovascular diseases (CVDs). Vulnerable plaques have specific morphological features that make their detection possible, hence allowing for identification of high-risk patients and the tailoring of therapy. Plaque ruptures predominantly occur amongst lesions characterized as thin-cap fibroatheromas (TCFA). Plaques without a rupture, such as plaque erosions, are also thrombi-forming lesions on the most frequent pathological intimal thickening or fibroatheromas. Many attempts to comprehensively identify vulnerable plaque constituents with different invasive and non-invasive imaging technologies have been made. In this review, advantages and limitations of invasive and non-invasive imaging modalities currently available for the identification of plaque components and morphologic features associated with plaque vulnerability, as well as their clinical diagnostic and prognostic value, were discussed.
动脉粥样硬化是一种脂蛋白驱动的炎症性疾病，导致动脉树的特定部位形成斑块。经过几十年的缓慢进展，动脉粥样硬化斑块破裂和血栓形成是导致急性冠状动脉综合征（ACS）发展的主要因素。在这方面，检测高风险（易损）斑块是动脉粥样硬化和心血管疾病（CVD）管理的最终目标。易损斑块具有特定的形态特征，使其能够被检测到，从而能够识别高危患者并进行治疗。斑块破裂主要发生在特征为薄帽纤维粥样瘤（TCFA）的病变中。没有破裂的斑块，如斑块侵蚀，也是最常见的病理性内膜增厚或纤维粥样瘤上形成血栓的病变。人们已经尝试使用不同的侵入性和非侵入性成像技术来全面识别易损斑块成分。在这篇综述中，讨论了目前可用于识别斑块成分和与斑块易损性相关的形态特征的侵入性和非侵入性成像方式的优缺点及其临床诊断和预后价值。
