Montarello Nicholas J, Nelson Adam J, Verjans Johan, Nicholls Stephen J, Psaltis Peter J
Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia.
Adelaide Medical School, University of Adelaide, Adelaide, Australia.
Cardiovasc Diagn Ther. 2020 Oct;10(5):1480-1507. doi: 10.21037/cdt-20-1.
Atherosclerotic cardiovascular disease is a key public health concern worldwide and leading cause of morbidity, mortality and health economic costs. Understanding atherosclerotic plaque microstructure in relation to molecular mechanisms that underpin its initiation and progression is needed to provide the best chance of combating this disease. Evolving vessel wall-based, endovascular coronary imaging modalities, including intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS), used in isolation or as hybrid modalities, have been advanced to allow comprehensive visualization of the pathological substrate of coronary atherosclerosis and accurately measure temporal changes in both the vessel wall and plaque characteristics. This has helped further our appreciation of the natural history of coronary artery disease (CAD) and the risk for major adverse cardiovascular events (MACE), evaluate the responsiveness to conventional and experimental therapeutic interventions, and assist in guiding percutaneous coronary intervention (PCI). Here we review the use of different imaging modalities for these purposes and the lessons they have provided thus far.
动脉粥样硬化性心血管疾病是全球主要的公共卫生问题，也是发病、死亡和健康经济成本的主要原因。为了提供对抗这种疾病的最佳机会，需要了解与动脉粥样硬化斑块起始和进展的分子机制相关的动脉粥样硬化斑块微观结构。不断发展的基于血管壁的血管内冠状动脉成像模式，包括血管内超声（IVUS）、光学相干断层扫描（OCT）和近红外光谱（NIRS），单独使用或作为混合模式使用，已经取得了进展，以实现冠状动脉粥样硬化病理基质的全面可视化，并准确测量血管壁和斑块特征的时间变化。这有助于我们进一步了解冠状动脉疾病（CAD）的自然史和主要不良心血管事件（MACE）的风险，评估对传统和实验性治疗干预的反应，并协助指导经皮冠状动脉介入治疗（PCI）。在此，我们综述了不同成像模式用于这些目的的情况以及它们迄今提供的经验教训。
