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

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.

Three-Tesla magnetic resonance imaging of left ventricular volume and function in comparison with computed tomography and echocardiography

“…[16] The value of cardiac CT in assessing cardiac function and the coronary artery morphology has also been increasingly recognized, especially multiple-slice CT (MSCT). [19][20][21] Most researchers have been focusing on the accuracy and reproducibility of each imaging technique, but readily ignored the interchangeable value of 1 technique to another. [18] The objective of this study was to investigate the correlation and agreement between cardiac 3-Tesla MRI and 256-slice MSCT or 2-dimensional ECHO in evaluation of cardiac volume and function.…”

Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment

“…Lp(a) also upregulates expression of urokinase and urokinase receptors on monocytes and, therefore, activation of plasmin that promotes ECM shrinkage [ 111 ]. A different mechanism refers to OxPLs, as a part of apo(a), that facilitate apoptosis of endoplasmic-reticulum-stressed macrophages and, therefore, plaque necrosis [ 112 , 113 ]. Lp(a), thus, possesses a crucial role not only in the early phases of atherosclerosis but also later during the sequence of events that result in destabilization of atherosclerotic plaques ( Figure 3 ).…”

“…Furthermore, several studies have demonstrated an association between circulating Lp(a) and restenosis after percutaneous transluminal coronary angioplasty (PTCA). Lp(a) has been described as an independent predictor of restenosis, with higher levels correlated with higher risk of restenosis [ 113 , 201 , 202 , 203 ] or with an increased degree of restenosis [ 204 ]. Nevertheless, studies that reveal no significant correlation between Lp(a) and restenosis after PTCA have been developed so far [ 205 , 206 ].…”

Developments and future prospects of personalized medicine in head and neck squamous cell carcinoma diagnoses and treatments

“…Performance of endoscopy, laryngoscopy, and biopsy is the invasive diagnostic procedures used traditionally 9,10 . At present, with the advancement of technology, apart from these invasive methods non‐invasive techniques such as computed tomography (CT) scan, positron emission tomography (PET), and magnetic resonance imaging (MRI) are followed as an early detection of HNSCC 11,12 …”

“…9,10 At present, with the advancement of technology, apart from these invasive methods non-invasive techniques such as computed tomography (CT) scan, positron emission tomography (PET), and magnetic resonance imaging (MRI) are followed as an early detection of HNSCC. 11,12 Surgery, chemotherapy, and radiation therapy are the presently used conventional methods in HNSCC treatment. However, these methods have serious adverse effects, impacting on the daily lifestyle/standards of living of patients.…”