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Predicting Plaque Rupture Risk in Vulnerable Atheroma: Insights from Advanced Imaging Techniques

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This article explores the prediction of plaque rupture risk in vulnerable atherosclerotic plaques, particularly thin-cap fibroatheromas (TCFAs). It evaluates the efficacy of various imaging techniques, such as CT, MRI, IVUS, and OCT, in identifying high-risk plaques and discusses the factors influencing rupture, including plaque morphology and inflammatory markers. Additionally, the study highlights the potential implications for acute coronary syndrome (ACS) management and treatment strategies using pharmacological agents like ACE inhibitors and ARBs.

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Predicting Plaque Rupture Risk in Vulnerable Atheroma: Insights from Advanced Imaging Techniques

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    1. ?????????????????????? ???????? ? ?

    3. ????????????? ??????????(vulnerable plaque)???????????????(ACS)??????? ??????????????????????????? ????????????????????????(thin-cap fibroatheroma, TCFA)

    4. ACS?????

    5. Thin-Cap FibroAtheroma

    6. ??????? ????????(>40% ????) ????? (<65µm) ????????T??????????? ???????????????? ?????? ?????? ????

    7. vulnerable plaque

    8. ????????? ??-???? ??-???? ????-?? ?????? ???????? ????????

    9. ??????

    10. ??????

    11. ?????????????? ??????????????,??????? ???????????P4Ha(I)?????TNF-a????,??NonO???????? ??????SiRNA??NonO??,TNF-a?????P4Ha(1)??????70%,??????ASK1-JNK????? ?????????????????????????????

    12. ??????????????

    13. ??—????

    14. ??? ? J Cell Physiol, 2010, Published Online May 27 2010 ??? ? J Cell Physiol, 2010, Published Online May 27 2010

    15. ??—????

    19. ??????????? ????????????????,?????????(AF)??????????? ??Smad, MAPK ???????????????AF????????? ???????????(Gax)????????????????AF???

    20. ????????? ???????????????????????????,??????????????? ??????????????????,????????????????

    22. ??????? ??????? ?????? ????? CT?? ????? ?????? ????? ???????? ????????

    23. ???????

    24. ??????????????????

    26. ?????????????????? ?????????????????????????????? ????????????????????

    27. ????????????????

    28. Prediction of Plaque Rupture by VVI

    29. Prediction of Plaque Rupture by VVI Binary logistic regression model Strain HR 95%CI p LSp (%) 0.386 0.1454~0.820 0.007 CSp (%) 8.446 5.904~9.104 0.001 RSp (%) 8.963 5.358~10.486 0.001

    30. Prediction of Plaque Rupture by VVI CSp: Cut-off: 0.268% Sensitivity: 88.6% Specificity: 92.0% AUC: 0.965 RSp: Cut-off: 0.296% Sensitivity: 88.0% Specificity: 88.6% AUC: 0.963

    31. ????????

    32. CT????????? ?????? ?????,???????????,??CT?<50 HU ?????????,?????????? ??????????? CT???? ??????????????? ????????????CT??????,??????????????????

    33. MRI????????? ?????? ??????:T2WI?????? ????????? ????????:?????????,???????????????? MRI???? ??????????????????????????????,????????????????????????? ??????????????

    34. ????????????? ?????? ????:????????????????,????????? AMI?????????????,????????? ???????? ????????????????????????? ?????????“????”???AS?? ???AS?????????????,????????????????

    35. IVUS????????? ?????? ???????????? ??????? ????????????,?????????,????????? IVUS???? ??????????? ?????????

    36. ?????IVUS??

    37. ??????????

    38. ???????????????

    39. OCT????????? OCT??? ??????<65µm??????????????100% ????????????????????????? ???????????????? ?????????????????????

    40. OCT????????? ?????? ???????????????????????? ?????????? ???????????? OCT???? ???OCT???????????,????????????????????,??????????, ???OCT?????? ????????

    41. ???????????

    45. ?????????? ????????? ????????? ????????? ?????????

    46. ?????????? ??????? ????? ACEI?ARB ß????? ?????? ?????? ????

    47. ??????? ????? ????? ????? ????? ???? ???? ????

    48. ????? ????LDL-C??,??????????????????????????????????????????? ?????????????????,???????????? ??????????????????,????????????? ?????????,???????

    50. RAS??? ACEI?ARB??????????AS?????? ???? ??????????????ACEI?ARB??????,??????????????????????? ???????????AS??????? LVEF???????,?????????????????????????????????????????,??ACEI???????

    51. RAS??? ACEI?ARB??ACS???????????? ??????? AMI??24h??????(????????????????????????) AMI??24h???????????????????????????? ??????????????????

    53. ß?????????? ß????????????,?????? ?????????,???????? ????????????????????ß????????????,????ß??? ß????????????????????

    54. ?????? ???????????????????????????????????????? ?????????????????????? ?????????????????? ??????????????????????

    55. ?????? ???????,?????????????????????>70%????????????,??????????? ???????????,???????????????????????????????

    56. ?????????????

    57. MCP-1???????????

    63. Effects of Chinese Medicine TXL Incidence of Plaque Rupture Group A 73.3% (11/15) Group D1 14.3% (2/14) Group D2 7.1% (1/14) Group D3 7.7% (1/13) Group E 7.1% (1/14) (Bars = 20µm)

    64. Effects of TXL on Plaques

    65. AS??????????????ACS??????? ??—?????????????? ????????????????????? ??????????ACEI?ARB? ß???????????????????????????????,??????????

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