Cardiology Department, University of Parma, 43126 Parma, Italy.
Cardiology Department, Azienda Ospedaliero-Universitaria of Parma, 43126 Parma, Italy.
Int J Mol Sci. 2023 Mar 8;24(6):5155. doi: 10.3390/ijms24065155.
Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality worldwide. Several cardiovascular risk factors are implicated in atherosclerotic plaque promotion and progression and are responsible for the clinical manifestations of coronary artery disease (CAD), ranging from chronic to acute coronary syndromes and sudden coronary death. The advent of intravascular imaging (IVI), including intravascular ultrasound, optical coherence tomography and near-infrared diffuse reflectance spectroscopy has significantly improved the comprehension of CAD pathophysiology and has strengthened the prognostic relevance of coronary plaque morphology assessment. Indeed, several atherosclerotic plaque phenotype and mechanisms of plaque destabilization have been recognized with different natural history and prognosis. Finally, IVI demonstrated benefits of secondary prevention therapies, such as lipid-lowering and anti-inflammatory agents. The purpose of this review is to shed light on the principles and properties of available IVI modalities along with their prognostic significance.
动脉粥样硬化性心血管疾病是全球发病率和死亡率的主要原因。几种心血管危险因素与动脉粥样硬化斑块的促进和进展有关，并导致了冠状动脉疾病（CAD）的临床表现，从慢性到急性冠状动脉综合征和猝死不等。血管内成像（IVI）的出现，包括血管内超声、光相干断层扫描和近红外漫反射光谱，极大地提高了对 CAD 病理生理学的理解，并增强了冠状动脉斑块形态评估的预后相关性。事实上，已经认识到几种动脉粥样硬化斑块表型和斑块不稳定的机制，它们具有不同的自然史和预后。最后，IVI 证明了二级预防治疗（如降脂和抗炎药物）的益处。本综述的目的是阐明现有的 IVI 方式的原理和特性及其预后意义。
