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Cardiovascular Imaging in Racial/Ethnic Populations: Implications for the Adequate Application of Cardiovascular Imaging Techniques Guided by Racial/Ethnic Risk Factor Variations

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Cardiovascular Disease in Racial and Ethnic Minorities

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Over the last decade, the increased research focus on cardiovascular imaging for the identification of patients at risk for and with significant coronary artery disease (CAD) has augmented clinician awareness and ability to properly risk stratify and categorize patients. Cardiac imaging has now become a technique not only for assessing patients with established CAD but also for the identification of patients with subclinical CAD who are at risk for ischemic heart disease and cardiac events of death and myocardial infarction. The Multi-Ethnic Study of Atherosclerosis (MESA) is a 10-year longitudinal study supported by the National Heart, Lung, and Blood Institute with the goals of identifying and quantifying risk factors for subclinical atherosclerosis, and for transition in patients from subclinical disease to clinically apparent events. Cardiac imaging findings from MESA with respect to racial/ethnic differences reveal that the incidence and prevalence of CAD differ among some racial/ethnic groups in the United States. The large number of patients affected by CAD has driven the development of effective, non-invasive methods to identify and risk-stratify patients with and at risk for CAD. When patients are properly identified, the appropriate treatment strategies can be applied to individual patients to prevent future events, such as death or myocardial infarction. Historically, exercise treadmill testing (ETT) with electrocardiogram (ECG) monitoring was the initial test applied to patients suspected of having CAD. Today, non-invasive cardiovascular testing with imaging has become the gold standard for the diagnostic and prognostic assessment of patients with suspected or known cardiovascular disease.

Most of the diagnostic non-invasive imaging tests currently available are based on assessment of regional and global function (echocardiography, radionuclide angiography, magnetic resonance imaging [MRI]), myocardial perfusion (single-photon emission computed tomography (CT), contrast-enhanced MRI), or coronary anatomy (CT angiography, magnetic resonance angiography) under resting conditions, stress conditions, or both. Diagnostic techniques such as electron beam CT, multi-slice cardiac CT scanning, and measurement of carotid intimal–medial thickness have emerged in recent years for detecting asymptomatic coronary or carotid atherosclerosis. Recent data on the assessment of long-term prognosis based upon the results of imaging tests to define false results has been shown to be reliable and helpful in risk prediction of cardiac events. In daily clinical practice, the assessment of risk allows for the identification of subsets of patients.

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Author information

Authors and Affiliations

  1. North Shore University Hospital, Manhasset, NY, USA

    A. N. Makaryus MD

  2. New York University School of Medicine, New York, NY, USA

    J. H. Mieres MD

  3. Emory University School of Medicine, Atlanta, GA, USA

    L. J. Shaw PhD

Authors
  1. A. N. Makaryus MD
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  2. J. H. Mieres MD
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  3. L. J. Shaw PhD
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Editor information

Editors and Affiliations

  1. Cardiology Division, Emory University, 5355 Hunter Road, Atlanta, GA, 30349, USA

    Keith C. Ferdinand MD

  2. Department of Internal Medicine, New Hanover Regional Medical Center, 212 Walnut Street, Wilmington, NC, 28401 #101, USA

    Annemarie Armani MD

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© 2009 Humana Press, a part of Springer Science+Business Media, LLC

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Makaryus, A.N., Mieres, J.H., Shaw, L.J. (2009). Cardiovascular Imaging in Racial/Ethnic Populations: Implications for the Adequate Application of Cardiovascular Imaging Techniques Guided by Racial/Ethnic Risk Factor Variations. In: Ferdinand, K.C., Armani, A. (eds) Cardiovascular Disease in Racial and Ethnic Minorities. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-410-0_12

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  • DOI: https://doi.org/10.1007/978-1-59745-410-0_12

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-981-9

  • Online ISBN: 978-1-59745-410-0

  • eBook Packages: MedicineMedicine (R0)

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