Current Concepts and Future Applications of Non-Invasive Functional and Anatomical Evaluation of Coronary Artery Disease

Overview

Journal Life (Basel)

Specialty Biology

Date 2022 Nov 11

PMID 36362957

Authors

Evangelos Oikonomou

Panagiotis Theofilis

Stamatios Lampsas

Ourania Katsarou

Konstantinos Kalogeras

Georgios Marinos

Aikaterini Tsatsaragkou

Artemis Anastasiou

Antonios Lysandrou

Maria-Ioanna Gounaridi

Ioannis Gialamas

Michael-Andrew Vavuranakis

Dimitris Tousoulis

Manolis Vavuranakis

Gerasimos Siasos

Affiliations

Soon will be listed here.

Abstract

Over the last decades, significant advances have been achieved in the treatment of coronary artery disease (CAD). Proper non-invasive diagnosis and appropriate management based on functional information and the extension of ischemia or viability remain the cornerstone in the fight against adverse CAD events. Stress echocardiography and single photon emission computed tomography are often used for the evaluation of ischemia. Advancements in non-invasive imaging modalities such as computed tomography (CT) coronary angiography and cardiac magnetic resonance imaging (MRI) have not only allowed non-invasive imaging of coronary artery lumen but also provide additional functional information. Other characteristics regarding the plaque morphology can be further evaluated with the latest modalities achieving a morpho-functional evaluation of CAD. Advances in the utilization of positron emission tomography (PET), as well as software advancements especially regarding cardiac CT, may provide additional prognostic information to a more evidence-based treatment decision. Since the armamentarium on non-invasive imaging modalities has evolved, the knowledge of the capabilities and limitations of each imaging modality should be evaluated in a case-by-case basis to achieve the best diagnosis and treatment decision. In this review article, we present the most recent advances in the noninvasive anatomical and functional evaluation of CAD.

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References

Patel K, Al Badarin F, Chan P, Spertus J, Courter S, Kennedy K . Randomized Comparison of Clinical Effectiveness of Pharmacologic SPECT and PET MPI in Symptomatic CAD Patients. JACC Cardiovasc Imaging. 2019; 12(9):1821-1831. PMC: 7061443. DOI: 10.1016/j.jcmg.2019.04.020. View

Gohmann R, Pawelka K, Seitz P, Majunke N, Heiser L, Renatus K . Combined cCTA and TAVR Planning for Ruling Out Significant CAD: Added Value of ML-Based CT-FFR. JACC Cardiovasc Imaging. 2021; 15(3):476-486. DOI: 10.1016/j.jcmg.2021.09.013. View

Fichtlscherer S, Heeschen C, Zeiher A . Inflammatory markers and coronary artery disease. Curr Opin Pharmacol. 2004; 4(2):124-31. DOI: 10.1016/j.coph.2004.01.002. View

Rubeaux M, Joshi N, Dweck M, Fletcher A, Motwani M, Thomson L . Motion Correction of 18F-NaF PET for Imaging Coronary Atherosclerotic Plaques. J Nucl Med. 2015; 57(1):54-9. DOI: 10.2967/jnumed.115.162990. View

Blaha M, Whelton S, Al Rifai M, Dardari Z, Shaw L, Al-Mallah M . Comparing Risk Scores in the Prediction of Coronary and Cardiovascular Deaths: Coronary Artery Calcium Consortium. JACC Cardiovasc Imaging. 2020; 14(2):411-421. PMC: 7343587. DOI: 10.1016/j.jcmg.2019.12.010. View

Yu A, Raikhelkar J, Zabor E, Tonorezos E, Moskowitz C, Adsuar R . Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer. Biomed Res Int. 2016; 2016:9363951. PMC: 4749762. DOI: 10.1155/2016/9363951. View

Adamson P, Dweck M, Newby D . The vulnerable atherosclerotic plaque: in vivo identification and potential therapeutic avenues. Heart. 2015; 101(21):1755-66. DOI: 10.1136/heartjnl-2014-307099. View

Porter T, Smith L, Wu J, Thomas D, Haas J, Mathers D . Patient outcome following 2 different stress imaging approaches: a prospective randomized comparison. J Am Coll Cardiol. 2013; 61(24):2446-2455. DOI: 10.1016/j.jacc.2013.04.019. View

Knuuti J, Ballo H, Juarez-Orozco L, Saraste A, Kolh P, Rutjes A . The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability. Eur Heart J. 2018; 39(35):3322-3330. DOI: 10.1093/eurheartj/ehy267. View

10.

Economou E, Oikonomou E, Siasos G, Papageorgiou N, Tsalamandris S, Mourouzis K . The role of microRNAs in coronary artery disease: From pathophysiology to diagnosis and treatment. Atherosclerosis. 2015; 241(2):624-33. DOI: 10.1016/j.atherosclerosis.2015.06.037. View

11.

Sandesara P, Mehta A, ONeal W, Kelli H, Sathiyakumar V, Martin S . Clinical significance of zero coronary artery calcium in individuals with LDL cholesterol ≥190 mg/dL: The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2019; 292:224-229. DOI: 10.1016/j.atherosclerosis.2019.09.014. View

12.

Badimon L, Vilahur G . Thrombosis formation on atherosclerotic lesions and plaque rupture. J Intern Med. 2014; 276(6):618-32. DOI: 10.1111/joim.12296. View

13.

Falk E, Shah P, Fuster V . Coronary plaque disruption. Circulation. 1995; 92(3):657-71. DOI: 10.1161/01.cir.92.3.657. View

14.

Ibanez B, James S, Agewall S, Antunes M, Bucciarelli-Ducci C, Bueno H . 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European.... Eur Heart J. 2017; 39(2):119-177. DOI: 10.1093/eurheartj/ehx393. View

15.

Kitagawa K, Nakamura S, Ota H, Ogawa R, Shizuka T, Kubo T . Diagnostic Performance of Dynamic Myocardial Perfusion Imaging Using Dual-Source Computed Tomography. J Am Coll Cardiol. 2021; 78(20):1937-1949. DOI: 10.1016/j.jacc.2021.08.067. View

16.

Spacek M, Zemanek D, Hutyra M, Sluka M, Taborsky M . Vulnerable atherosclerotic plaque - a review of current concepts and advanced imaging. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018; 162(1):10-17. DOI: 10.5507/bp.2018.004. View

17.

Moss A, Doris M, Andrews J, Bing R, Daghem M, van Beek E . Molecular Coronary Plaque Imaging Using F-Fluoride. Circ Cardiovasc Imaging. 2019; 12(8):e008574. PMC: 7668410. DOI: 10.1161/CIRCIMAGING.118.008574. View

18.

Kwiecinski J, Cadet S, Daghem M, Lassen M, Dey D, Dweck M . Whole-vessel coronary F-sodium fluoride PET for assessment of the global coronary microcalcification burden. Eur J Nucl Med Mol Imaging. 2020; 47(7):1736-1745. PMC: 7271818. DOI: 10.1007/s00259-019-04667-z. View

19.

de Knegt M, Rossi A, Petersen S, Wragg A, Khurram R, Westwood M . Stress myocardial perfusion with qualitative magnetic resonance and quantitative dynamic computed tomography: comparison of diagnostic performance and incremental value over coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging. 2020; . DOI: 10.1093/ehjci/jeaa270. View

20.

Pezel T, Hovasse T, Lefevre T, Sanguineti F, Unterseeh T, Champagne S . Prognostic Value of Stress CMR in Symptomatic Patients With Coronary Stenosis on CCTA. JACC Cardiovasc Imaging. 2022; 15(8):1408-1422. DOI: 10.1016/j.jcmg.2022.03.008. View