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Bioimaging and Subclinical Cardiovascular Disease in Low- and Middle-Income Countries

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Abstract

Cardiovascular disease (CVD) is the leading cause of mortality worldwide and also exerts a significant economic burden, especially in low- and middle-income countries (LMICs). Detection of subclinical CVD, before an individual experiences a major event, may therefore offer the potential to prevent or delay morbidity and mortality, if combined with an appropriate care response. In this review, we discuss imaging technologies that can be used to detect subclinical atherosclerotic CVD (carotid ultrasound, coronary artery calcification) and nonatherosclerotic CVD (echocardiography). We review these imaging modalities, including aspects such as rationale, relevance, feasibility, utilization, and access in LMICs. The potential gains in detecting subclinical CVD may be substantial in LMICs, if earlier detection leads to earlier engagement with the health care system to prevent or delay cardiac events, morbidity, and premature mortality. Thus, dedicated studies examining the feasibility, utility, and cost-effectiveness of detecting subclinical CVD in LMICs are warranted.

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Abbreviations

CAC:

Coronary artery calcium

cIMT:

Carotid intima-media thickness

cPB:

Carotid plaque burden

cUS:

Carotid ultrasound

CVD:

Cardiovascular disease

DALY:

Disability-adjusted life years

HRP:

High-risk plaque

LMICs:

Low- and middle-income countries

RHD:

Rheumatic heart disease

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Acknowledgments

The authors would like to thank Claire Hutchinson for editorial assistance.

Funding

RV is supported by the Fogarty International Center of the National Institutes of Health under Award Number K01 TW 009218-03. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA

    Rajesh Vedanthan, Usman Baber, Jagat Narula & Valentin Fuster

  2. The GW Heart & Vascular Institute and Cheney Center for Cardiovascular Health, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA

    Brian G. Choi

  3. Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain

    Valentin Fuster

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  1. Rajesh Vedanthan
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  2. Brian G. Choi
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Correspondence to Valentin Fuster.

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Associate Editor Daniel P. Judge oversaw the review of this article

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Vedanthan, R., Choi, B.G., Baber, U. et al. Bioimaging and Subclinical Cardiovascular Disease in Low- and Middle-Income Countries. J. of Cardiovasc. Trans. Res. 7, 701–710 (2014). https://doi.org/10.1007/s12265-014-9588-y

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