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Vulnerable atherosclerotic plaque features:findings from coronary imaging

Journal of Geriatric Cardiology 2021年第7期18卷 577-584页

作者： Osamu Kurihara Masamichi Takano yasushi miyauchi Kyoichi Mizuno Wataru Shimizu Cardiovascular Center Chiba Hokusoh HospitalNippon Medical SchoolChibaJapan Mitsukoshi Health and Welfare Foundation TokyoJapan Division of Cardiology Nippon Medical SchoolTokyoJapan

Pathological studies have suggested that features of vulnerable atherosclerotic plaques likely to progress and lead to acute cardiovascular events have specific characteristics.Given the progress of intravascular coronary imaging technology,some large prospective studies have detected features of vulnerable atherosclerotic plaques using these imaging modalities.However,the rate of cardiovascular events,such as acute coronary syndrome,has been found to be considerably reduced in the limited follow-up period available in the statin era.Additionally,not all disrupted plaques lead to thrombus formation with clinical presentation.If sub-occlusive or occlusive thrombus formation does not occur,a thrombus on a disrupted plaque will organize without any symptoms,forming a"healed plaque".Although vulnerable plaque detection using intracoronary imaging is focused on"thin-cap fibroatheroma"leading to plaque rupture,superficial plaque erosion is increasingly recognized;however,the underlying mechanism of thrombus formation on eroded plaques is not well understood.One of intravascular imaging,optical coherence tomography(OCT)has the highest image resolution and has enabled detailed characterization of the plaque in vivo.Here,we reviewed the status and limitations of intravascular imaging in terms of detecting vulnerable plaque through mainly OCT studies.We suggested that vulnerable plaque should be reconsidered in terms of eroded plaque and healed plaque and that both plaque and circulating blood should be assessed in greater detail accordingly.

关键词： coronary acute superficial

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Are angiographic culprit lesions true?Disagreement between angiographic and optical coherence tomographic detection

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Journal of Geriatric Cardiology 2021年第10期18卷 844-846页

作者： Osamu Kurihara Masamichi Takano Yusaku Shibata Nobuaki Kobayashi yasushi miyauchi Kuniya Asai Cardiovascular Center Nippon Medical School Chiba Hokusoh HospitalInzaiChibaJapan Division of Intensive Care Unit Nippon Medical School Chiba Hokusoh HospitalInzaiChibaJapan

Coronary angiography provides a two-dimensional silhouette of the vascular lu-men.It is the gold standard for the dia-gnosis of coronary artery disease and is essential during percutaneous coronary intervention(PCI).

关键词： coronary lesions Coronary

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