Canu Marjorie, Broisat Alexis, Riou Laurent, Vanzetto Gerald, Fagret Daniel, Ghezzi Catherine, Djaileb Loic, Barone-Rochette Gilles
Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France.
Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France.
Front Cardiovasc Med. 2022 Feb 24;9:836473. doi: 10.3389/fcvm.2022.836473. eCollection 2022.
Atherosclerotic plaque rupture or erosion remain the primary mechanism responsible for myocardial infarction and the major challenge of cardiovascular researchers is to develop non-invasive methods of accurate risk prediction to identify vulnerable plaques before the event occurs. Multimodal imaging, by CT-TEP or CT-SPECT, provides both morphological and activity information about the plaque and cumulates the advantages of anatomic and molecular imaging to identify vulnerability features among coronary plaques. However, the rate of acute coronary syndromes remains low and the mechanisms leading to adverse events are clearly more complex than initially assumed. Indeed, recent studies suggest that the detection of a state of vulnerability in a patient is more important than the detection of individual sites of vulnerability as a target of focal treatment. Despite this evolution of concepts, multimodal imaging offers a strong potential to assess patient's vulnerability. Here we review the current state of multimodal imaging to identify vulnerable patients, and then focus on emerging imaging techniques and precision medicine.
动脉粥样硬化斑块破裂或糜烂仍然是导致心肌梗死的主要机制，心血管研究人员面临的主要挑战是开发非侵入性的准确风险预测方法，以便在事件发生前识别易损斑块。通过CT-TEP或CT-SPECT进行的多模态成像可提供有关斑块的形态学和活性信息，并累积了解剖学和分子成像的优势，以识别冠状动脉斑块中的易损特征。然而，急性冠状动脉综合征的发生率仍然较低，导致不良事件的机制显然比最初设想的更为复杂。事实上，最近的研究表明，检测患者的易损状态比检测作为局部治疗靶点的个体易损部位更为重要。尽管概念有所演变，但多模态成像在评估患者易损性方面具有强大的潜力。在此，我们综述了用于识别易损患者的多模态成像的现状，然后重点介绍新兴的成像技术和精准医学。
