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Atherosclerotic Plaque Imaging
Contemporary Role in Preventive Cardiology
Paolo Raggi, MD;
Allen Taylor, MD;
Zahi Fayad, PhD;
Daniel OLeary, MD;
Steven Nissen, MD;
Daniel Rader, MD;
Leslee J. Shaw, PhD
Arch Intern Med. 2005;165:2345-2353.
Coronary artery disease imaging has traditionally been based on luminal angiography, but it has become evident that this tool, although extremely useful in diagnosing obstructive disease, is insufficient to define the presence and extent of atherosclerotic disease in the vessel wall. Progression of coronary artery disease was also initially evaluated using quantitative coronary angiography, and evidence soon accumulated that minor regression or nonprogression of luminal disease was associated with a favorable cardiovascular outcome. In recent years, however, several other techniques have been developed to image atherosclerosis and are emerging as useful tools in preventive cardiovascular medicine. These techniques provide new methods to assess the burden of atherosclerosis, gauge the risk of cardiovascular events, and offer a means to test the efficacy of therapeutic approaches to atherosclerosis. Furthermore, noninvasive coronary angiography can be performed with some of the new imaging modalities, potentially reducing the number of unnecessary invasive tests. This review focuses on techniques such as cardiac computed tomography, carotid artery intima-media thickness, cardiovascular magnetic resonance imaging, and intravascular ultrasonography as emerging tools in cardiovascular disease prevention.
Author Affiliations: Section of Cardiology, Department of Internal Medicine, Tulane University School of Medicine, New Orleans, La (Dr Raggi); Division of Cardiology, Walter Reed Army Medical Center, Washington, DC (Dr Taylor); Departments of Cardiology and Radiology, Mount Sinai School of Medicine, New York, NY (Dr Fayad); Department of Radiology, Tufts-New England Medical Center, Boston, Mass (Dr OLeary); Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio (Dr Nissen); Division of Endocrinology, Department of Internal Medicine, University of Pennsylvania, Philadelphia (Dr Rader); and Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, Calif (Dr Shaw).
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