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Clinical Feasibility and Monitoring of the Effects of Anti-inflammatory Therapy in Atherosclerosis

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Cardiovascular Imaging

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Abstract

Atherosclerosis and its thrombotic complications represent the major cause of morbidity and mortality of cardiovascular disease. The composition of atherosclerotic plaques rather than the degree of arterial stenosis has been linked to an increased risk of plaque rupture and subsequent acute clinical events associated with atherosclerotic cardiovascular disease. Vulnerable plaques have a large lipid-rich necrotic core, a thin-fibrous cap, and numerous inflammatory and immune cells. Above all, macrophage activation plays a central role in vascular inflammation and plaque instability within the atherosclerosis. However, we have yet to clinically demonstrate vascular inflammation in atherosclerosis assessed by computed tomography angiography, magnetic resonance imaging, intravascular ultrasound, and optical coherence tomography. Molecular imaging is the tool best suited for identifying metabolically active macrophages. Positron-emission tomography (PET) imaging with 18F-fluorodeoxyglucose (FDG) is capable of identifying and quantifying vascular inflammation characterized by macrophage activation within the atherosclerotic plaques. FDG-PET might be a feasible clinical tool for detecting vulnerable plaques and evaluating the efficacy of drugs in plaque instability. We would like to review the clinical utility of FDG-PET imaging in identifying patients at risk of plaque rupture and resultantly prone to cardiovascular disease.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, Japan

    Nobuhiro Tahara MD, PhD & Atsuko Tahara MD

  2. Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan

    Sho-ichi Yamagishi MD, PhD

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  1. Nobuhiro Tahara MD, PhD
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  2. Atsuko Tahara MD
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  3. Sho-ichi Yamagishi MD, PhD
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Correspondence to Nobuhiro Tahara MD, PhD .

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  1. Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, Massachusetts, USA

    Elena Aikawa

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Tahara, N., Tahara, A., Yamagishi, Si. (2015). Clinical Feasibility and Monitoring of the Effects of Anti-inflammatory Therapy in Atherosclerosis. In: Aikawa, E. (eds) Cardiovascular Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-09268-3_16

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