TY - JOUR
T1 - Comprehensive plaque assessment by coronary CT angiography
AU - Maurovich-Horvat, Pál
AU - Ferencik, Maros
AU - Voros, Szilard
AU - Merkely, Béla
AU - Hoffmann, Udo
N1 - Funding Information:
P.M-H. acknowledges support from the European Union, State of Hungary, and European Social Fund in the framework of TÁMOP 4.2.4. A/1-11-1-2012-0001 ‘National Excellence Program’. M.F. acknowledges support from the American Heart Association (grant number: 13FTF16450001).
PY - 2014/7
Y1 - 2014/7
N2 - Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future.
AB - Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future.
UR - http://www.scopus.com/inward/record.url?scp=84903265701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903265701&partnerID=8YFLogxK
U2 - 10.1038/nrcardio.2014.60
DO - 10.1038/nrcardio.2014.60
M3 - Review article
C2 - 24755916
AN - SCOPUS:84903265701
SN - 1759-5002
VL - 11
SP - 390
EP - 402
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
IS - 7
ER -