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Non-Invasive Imaging of Atherosclerosis : Developments in Cardiovascular Medicine - Karl A. Fox

Non-Invasive Imaging of Atherosclerosis

Developments in Cardiovascular Medicine

By: Karl A. Fox (Editor)

Hardcover Published: November 1997
ISBN: 9780792380368
Number Of Pages: 224

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Non-Invasive Imaging of Atherosclerosis is a primer, reference and review of some of the key features of current activities in the field of atherosclerosis. The Editors' goal is to provide material and stimulating ideas to basic scientists and clinical researchers in order to extend the application of vascular imaging and to further develop methods suitable for investigation of the arterial wall. The first section presents current knowledge about pathology, vascular mechanics and compensatory mechanisms active during atherogenesis. It explores the early lesion, complications of plaques and early detection of plaques. Section II reviews several key methodological issues of B-mode ultrasound imaging and some of the most current data. Quantitative B-mode ultrasound is an established non-invasive tool widely used in large epidemiologic studies and interventional clinical trials of atherosclerosis. The last section addresses the most promising areas of development in vascular imaging. This involves new techniques to evaluate the atherosclerotic bed, to follow atheroma progression/regression and to evaluate vascular mechanics in atherosclerotic arteries. The last chapter places the application of non-invasive imaging in perspective.

Industry Reviews

`Altogether, this is a very interesting book that provides a very complete overview of the current state and future applications of non-invasive imaging of atherosclerosis.'
International Journal of Cardiac Imaging, 15:185-186, 1999

Prefacep. xi
List of Contributorsp. xv
Pathology of Atherosclerosisp. 1
Carotid Atherosclerosis: From Induction to Complicationp. 3
Introductionp. 5
Pathogenesis of Carotid Atherosclerosisp. 5
Mechanical Determinants of Non-Atherosclerotic Intimal Thickeningp. 7
Atherosclerotic Intimal Thickeningp. 9
Stages of Atherosclerotic Lesionsp. 10
Arterial Adaptive Response to Developing Plaquep. 12
Plaque Neoformationp. 14
Features Indicative of Manifest or Imminent Plaque Disruptionp. 15
Chemical and Structural Composition of Critical Asymptomatic and Symptomatic Carotid Stenosesp. 16
Spatial Distribution of Plaque Components in Relation to the Artery Lumenp. 18
Conclusionp. 22
The Role of Atherosclerotic Plaque Disruption and Thrombosis in Acute Coronary Heart Diseasep. 27
Introductionp. 29
Hypothesis on the Origin of Atherosclerosisp. 29
Evolution of Atherosclerotic Lesionsp. 31
The Early Lesion (Stary type I, II)p. 31
Mature Plaques (Stary Type III, IV)p. 32
The Vulnerable Plaques (Stary Type IV and V)p. 32
Atherosclerotic Plaque Progressionp. 33
Slow Plaque Progressionp. 33
Rapid Plaque Progressionp. 34
Plaque Composition and Instabilityp. 35
Plaque Composition and Thrombogenicityp. 35
Arterial Thrombosis: The Clinical Manifestations of Atherosclerosisp. 37
Prevention of Plaque Disruptionp. 38
Plaque Stabilizationp. 38
Trigger Reductionp. 40
Detection and Monitoring of Atherosclerosisp. 47
Validity and Reproducibility of B-Mode Ultrasound in Imaging Carotid Intima-Media Thicknessp. 49
Introductionp. 51
Rationale for Developing Non Invasive Vascular Imagingp. 51
Definitions of Vascular Endpointsp. 52
Validityp. 53
Animal Experimentationsp. 53
The NIH Multicenter (US) Validation Studyp. 54
The Baylor College of Medicine Study on Atherosclerosis Progressionp. 54
The Pignoli's Experimentp. 56
Quantitative Methodsp. 58
Reproducibilityp. 60
Summaryp. 63
Endothelial Function and Non-Invasive Detection and Quantification of Brachial Artery Reactivityp. 65
Endothelium-dependent Vaso Relaxation, EDRF and NOp. 67
EDRFp. 67
Nitric Oxide and Its Physiologyp. 67
NO Releasep. 68
Shear-Stress-Induced Release of NO by the Endotheliump. 68
Cardiovascular Physiology of NOp. 68
Endothelial Dysfunction in Atherosclerosisp. 69
Mechanism underlying Endothelial Dysfunction in Atherosclerosisp. 69
Impaired NO Productionp. 69
Shortened NO Half-lifep. 70
Detection and Quantification of Endothelial Dysfunctionp. 70
Systemic Nature of Endothelial Dysfunctionp. 71
Non-Invasive Assessment of Brachial Artery Vasoreactivityp. 71
Vasodilation Test, Imaging and Data Acquisitionp. 71
Reproducibilityp. 74
Arterial Reactivity and Atherogenesisp. 75
Agingp. 75
Estrogensp. 76
Cigarette Smokingp. 76
Hypercholesterolemia and Risk Factor Interactionp. 77
Hypertensionp. 78
Diabetes Mellitusp. 79
Evaluation of Therapeutic Effectsp. 79
Summaryp. 81
Quantitative B-Mode Ultrasound Imaging in Observational Studiesp. 87
Introductionp. 89
Non-Invasive Assessment of Atherosclerosisp. 90
Description of Major Observational Studiesp. 91
Assessment of Intima-Media Thicknessp. 92
Near Wall and Far Wallp. 94
Quantifying Carotid Atherosclerosis Using Intima-Media Thicknessp. 94
Main Findings of Population-Based Studiesp. 96
Cross-sectional Resultsp. 96
Longitudinal Resultsp. 99
Conclusionp. 101
Interventional Clinical Trials on Carotid Atherosclerosis Progressionp. 105
Rationale for Interventional Clinical Trialsp. 107
Endpoints for Controlled Clinical Trials of Atherosclerosisp. 109
Clinical Trials with Antihypertensive Drugsp. 112
The Multicenter Isradipine/Diuretic Atherosclerosis Studyp. 113
Clinical Trials on Patients with Elevated LDL-cholesterolp. 115
The Pravastatin, Lipid and Atherosclerosis in the Carotid Arteriesp. 116
The Asymptomatic Carotid Artery Progression Studyp. 117
The Kuopio Atherosclerotic Plaque Studyp. 117
The Carotid Atherosclerosis Italian Ultrasound Studyp. 118
Other Ongoing Clinical Trialsp. 119
The Verapamil Hypertension Atherosclerosis Studyp. 120
The Perindopil Regression of Vascular Thickening European Community Trialp. 120
European Lacidipine Study on Atherosclerosisp. 121
The Plaque Hypertension Lipid Lowering Italian Studyp. 122
Significance and Limitations of Interventional Clinical Trialsp. 123
Summaryp. 124
Perspectives in Ultrasound Imagingp. 127
The Role of Mechanics in Vascular Biologyp. 129
Introduction: The Role of Mechanics in Vascular Biologyp. 131
Mechanical Analysis of Vascular Segmentsp. 132
Anatomy of the Arterial Wallp. 133
Basic Definitions and Assumptions Used in Vascular Mechanicsp. 135
Conventional Approaches to Describe the Vascular Mechanical Behaviorp. 140
Static Pressure, Thin-Walled Cylinder Approachp. 140
Static Pressure, Thick-Walled Cylinder Approachp. 141
Pulse Wave Velocity Approachp. 143
Analytical Determination of Stress-Strain (Constitutive) Relationshipsp. 143
Parametric Techniquesp. 144
Dynamic Analysesp. 145
Finite Element Analysesp. 146
Arterial Wall Properties in Aging and Diseasep. 147
Effects of Agingp. 147
Effects of Atherosclerosisp. 148
Effects of Hypertensionp. 150
High Resolution Ultrasound And Potential Applications to Vascular Mechanicsp. 150
Transcutaneous Ultrasoundp. 150
Intravascular Ultrasound Imagingp. 151
3D Reconstruction of Vascular Ultrasound Imagesp. 154
Finite Element Analysis of 3D Vascular Structuresp. 157
Summaryp. 162
Quantitative Ultrasonic Tissue Characterization with Intravascular and Transcutaneous Ultrasoundp. 169
Introduction: Quantitative Ultrasonic Tissue Characterization with Intravascular Ultrasoundp. 171
Quantitative Tissue Characterizationp. 171
Physiologic Vascular Structurep. 172
Aortic Aneurysmsp. 176
Atherosclerosisp. 179
Tissue Characterization With Intravascular Ultrasoundp. 181
Clinical Use of Quantitative Tissue Characterization With Intravascular Ultrasoundp. 183
Tissue Characterization with Transcutaneous Ultrasoundp. 185
The Image Processing Laboratoryp. 189
Introductionp. 191
Basic Concepts of Image Processingp. 191
Image Digitization, Display and Storagep. 193
Processing of Images: Enhancement and Edge Detectionp. 195
Variability within Vascular Ultrasoundp. 199
Three-Dimensional Vascular Reconstructionp. 201
Three-Dimensional Reconstruction of Intravascular Ultrasound Datap. 202
Three-Dimensional Reconstruction of Transcutaneous B-Mode Ultrasound Datap. 207
Use of Acoustic Properties to Characterize Plaque Componentsp. 211
Novel Uses of Ultrasoundp. 213
Liposomes and Other Targetable Agents for Acoustic Plaque Enhancementp. 213
Forward-Viewing Intravascular Ultrasoundp. 214
Acoustic Emissions to Characterize Plaque Rupturep. 217
Summaryp. 218
Potential Uses for Ultrasound Imaging in Clinical Trials of Atheroma Progression and Regressionp. 221
Introductionp. 223
Regression Trials: Where Have We Been?p. 223
Regression Trials: Where Are We Headed?p. 225
Which Patients Will Be Studied?p. 225
Which Treatments Will Be Studied?p. 227
Which Outcomes Will Be Measured?p. 228
Which Vascular Bed(s) Will Be Studied?p. 229
Which Imaging Methods Will Be Used?p. 229
Potential Role of Non-Invasive Ultrasound Imaging in Regression Trialsp. 230
Arterial Wall Thicknessp. 231
Plaque Characteristicsp. 231
Endothelial Dysfunctionp. 232
Blood Flow Characteristicsp. 232
Summaryp. 233
Indexp. 237
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9780792380368
ISBN-10: 0792380363
Series: Developments in Cardiovascular Medicine
Audience: General
Format: Hardcover
Language: English
Number Of Pages: 224
Published: November 1997
Publisher: Springer
Country of Publication: US
Dimensions (cm): 23.39 x 15.6  x 1.6
Weight (kg): 0.52