The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) Study

Tang, Tjun Yip; Howarth, Simon; Miller, Sam; Graves, Martin J.; Patterson, Andrew J.; U-King-Im, Jean Marie; Li, Zhi Y.; Walsh, Stewart R.; Brown, Andy; Kirkpatrick, Peter J.; Warburton, Elizabeth A.; Hayes, Paul D.; Varty, K.; Boyle, Jonathan R.; Gaunt, Michael E.; Zalewski, Andrew; Gillard, Jonathan H.

doi:10.1016/j.jacc.2009.03.018

Cited by 339 publications

(106 citation statements)

References 38 publications

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“…126,129,130 The versatility of MRI for atherosclerosis imaging has been enhanced by the development of contrast agents (nanoparticles) targeting specific constituents of human atheroma, especially monocytes/macrophages. [131][132][133][134] PET/CT is a highly sensitive and promising noninvasive approach for atherosclerosis imaging in humans. 135 The rationale behind the use of the glucose analog FDG is that active inflammatory cells within human atheroma, especially monocyte/macrophages, show increased metabolic activity and avidity for glucose.…”

Section: Atherosclerosis Imagingmentioning

confidence: 99%

“…126,129,130 La versatilidad de la RNM para las imágenes de ateroesclerosis ha sido intensificada por el desarrollo de agentes de contraste (nanopartículas) dirigidas a constituyentes específicos del ateroma humano, en especial monocitos/macrófagos. [131][132][133][134] La PET/TC es un abordaje altamente sensitivo y no invasivo prometedor para las imágenes de ateroesclerosis en los seres humanos. 135 El fundamento por detrás del uso del FDG análogo de la glucosa es que las células inflamatorias activas dentro del ateroma humano, especialmente monocitos/macró-fagos, muestran incremento de la actividad y avidez metabóli-ca por la glucosa.…”

Section: Imágenes De Infarto De Miocardiounclassified

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The Future of Cardiovascular Imaging

2016

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O ver the past 2 decades, we have witnessed an explosive expansion in the armamentarium of noninvasive and invasive imaging technologies capable of providing detailed information about the structure and function of the heart and vasculature. Many of these technologies are integrative (eg, positron emission tomography and computed tomography, positron emission tomography and MRI), thereby compounding the unique strengths of the component technologies to achieve unprecedented improvements to our ability to diagnose disease, improve patient care, and advance biomedical research. In addition, the miniaturization of imaging devices with dramatic increases in sensitivity and spatial resolution, coupled with the development of quantitative molecular imaging approaches for evaluating physiology and pathobiology at the cellular and molecular levels, provides a unique platform for a new era in diagnostic imaging. The crucial role of imaging in early phenotyping of disease, risk assessment, and management guidance is expanding rapidly in ways previously thought unrealistic.Along with clinical, molecular, and genomewide association studies, structural and functional quantitative imaging already plays a critical role in phenotyping cardiovascular disease. Unique strengths of imaging phenotyping include its ability to provide precise, organ-specific anatomic localization and quantification of disease traits, to demonstrate and quantify involvement of other organs in cardiac disease, to provide an opportunity to investigate the time course of disease-specific molecular events in vivo, and to track their response to therapy. In so doing, quantitative structural and functional imaging can provide a nuanced description of disease burden (eg, atherosclerosis, myocarditis), disease subtypes (eg, amyloidosis), and, importantly, the relationship between the specific phenotype and outcomes, thereby informing treatment strategies and allowing more personalized approaches to patient management.Our objectives for this article are to (1) provide a viewpoint regarding the evolving role of cardiovascular imaging in biomedical research and clinical practice, (2) discuss the challenges associated with clinical translation of imaging innovations and the opportunities for multimodality imaging in the changing paradigm of value-based medicine, and (3) briefly outline future challenges and opportunities including the requirements for training future generations of imaging scientists and clinical specialists. Unlike traditional reviews that provide a detailed discussion of the role of 1 or more imaging modalities in cardiovascular (CV) disease, our discussion will focus on the potential role of imaging in what we believe are key areas of the translational highway with specific examples on how structural and functional imaging may contribute to scientific discovery, diagnosis, risk stratification, and patient management in each of those areas. Redefining the Role of Imaging Across the Continuum of Biomedical Research and Clinical Practice Translati...

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Section: Atherosclerosis Imagingmentioning

confidence: 99%

Section: Imágenes De Infarto De Miocardiounclassified

The Future of Cardiovascular Imaging

2016

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“…Adapted from Puri et al 143 193 In the Atorvastatin Therapy: Effects on Reduction of Macrophage Activity (ATHEROMA) study, reduction in carotid plaque inflammation in response to high-dose statin treatment was observed using USPIO MRI after just 3 months. 194 Effects of the anti-inflammatory IL-1β monoclonal antibody canakinumab on carotid plaque burden will be quantified using MRI in a prespecified substudy of Cardiovascular Risk Reduction Study, Reduction in Recurrent Major CV Disease Events (CANTOS; NCT01327846). Although CCTA can potentially provide a useful noninvasive means of monitoring effects of drugs on coronary plaque volume and composition in noncalcified lesions, 195 further evaluation of this application is needed, particularly in view of the added radiation risk.…”

Section: Intravascular Imaging: Ivus and Octmentioning

confidence: 99%

Imaging of atherosclerosis

Takx

Partovi

Ghoshhajra

2015

Int J Cardiovasc Imaging

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Advances in atherosclerosis imaging technology and research have provided a range of diagnostic tools to characterize high-risk plaque in vivo; however, these important vascular imaging methods additionally promise great scientific and translational applications beyond this quest. When combined with conventional anatomic-and hemodynamic-based assessments of disease severity, cross-sectional multimodal imaging incorporating molecular probes and other novel noninvasive techniques can add detailed interrogation of plaque composition, activity, and overall disease burden. In the catheterization laboratory, intravascular imaging provides unparalleled access to the world beneath the plaque surface, allowing tissue characterization and measurement of cap thickness with micrometer spatial resolution. Atherosclerosis imaging captures key data that reveal snapshots into underlying biology, which can test our understanding of fundamental research questions and shape our approach toward patient management. Imaging can also be used to quantify response to therapeutic interventions and ultimately help predict cardiovascular risk. Although there are undeniable barriers to clinical translation, many of these hold-ups might soon be surpassed by rapidly evolving innovations to improve image acquisition, coregistration, motion correction, and reduce radiation exposure. This article provides a comprehensive review of current and experimental atherosclerosis imaging methods and their uses in research and potential for translation to the clinic. (Circ Res. 2016;118:750-769.

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“…The study randomly assigned patients into two treatment arms, low- (10 mg) and high-dose (80 mg) atorvastatin therapy, over 12 weeks, and assessed the dose-response interaction [10]. The purpose of this preliminary evaluation of long-term follow-up is to report on the ability of initial USPIO-enhanced MRI to predict subsequent cerebrovascular and cardiovascular morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…All study participants (n = 62) initially screened for recruitment into the ATHEROMA trial [10] were retrospectively examined for the occurrence of cerebrovascular events, cardiovascular events and mortality following initial imaging with USPIO. Symptomatic status was defined as the occurrence of a cerebrovascular event (transient ischaemic attack and stroke) or cardiovascular event (myocardial infarction) to encompass the systemic risk nature of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%