Introduction topical issue on CT plaque burden
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INTRODUCTION
Introduction topical issue on CT plaque burden Johan H. C. Reiber1
© Springer Nature B.V. 2020
It has taken some time to put this Topical Issue together, but I believe that we do have now a very nice and very upto-date collection of Review and Overview papers on the various topics associated with the very interesting and timely field of the CT Plaque Burden. Before we begin, I would like to thank all the authors who have contributed to this nice Topical Issue. This Topical Issue starts with a Review on the topic of serial CTA to assess plaque progression and the therapeutic effects of anti-atherosclerotic drugs by Jana Taron et al. of the group of Udo Hoffmann at Mass General in Boston, USA [1]. This team has a long history of research in this field. Because CTA is noninvasive, it allows for setting up and enabling clinical trials with lower-risk populations, higher retention rates, and lower costs. For these important reasons they see an increasing interest and usage of serial CTA as an imaging endpoint in clinical trials. The next review paper by Parastou Eslami is from the same group [2]. Given the high spatial and temporal resolution of the modern CT scanners, it is now possible to assess the presence, morphology and composition of coronary atherosclerosis and derive high risk features from the Plaque Burden analyses, such as large plaque volume, low CT attenuation, napkin-ring sign, spotty calcification and positive remodeling. However, in this overview the group examines the value of lesion-specific hemodynamics, such as endothelial shear stress, fractional flow reserve and plaque stress. They believe that this combination of anatomic and hemodynamic information allows the identification of lesions at risk for rupture earlier than only on the basis of anatomic information. Dr Suvanini Lakshmanan of the team of Matthew J Budoff in Torrance, California, USA wrote a review about the benefits of imaging and plaque analysis in serial coronary CTA for the evaluation of cardiovascular risk analysis * Johan H. C. Reiber [email protected] 1
and targeted treatment of coronary artery disease [3]. They believe that whole-heart quantification and characterization of coronary atherosclerotic plaque burden on CTA allows the transition form identifying a “vulnerable” plaque to the “vulnerable” patient. Dr Nestor Gahungu from the University of Ottawa Heart Institute, Canada under the leadership of Dr Benjamin J Chow and Dr Girish Dwivedi studied the differences in plaque scores between a South Asian population and matched Caucacian population [4]. They found no differences in low, intermediate, and high-attenuation or calcified normalized plaque volumes, and after a follow-up period of 32 months, the major adverse cardiovascular events were also similar. Since South Asian populations experience poorer cardiovascular outcomes in general, other factors need to be investigated. In the next paper by Dr Sang-Eun Lee together with many co-authors from multiple centers, all under the supervision of dr Hyuk-Jae
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