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What Is Plugging Your Heart Arteries? Plaque Formation, Types of Plaque, and Plaque Rupture
Published in Mark C Houston, The Truth About Heart Disease, 2023
Plaque regression and change from vulnerable to non-vulnerable plaque are possible with various treatments such as aspirin, statins, blood pressure medications (such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB)), and high levels of the good high-density lipoprotein (HDL) that functions well. Various supplements, such as vitamin K2 MK 7, omega-3 fatty acids, niacin, luteolin (celery, green pepper, rosemary, carrots, oregano, oranges, olives), curcumin, quercetin, magnesium, grape seed extract, N acetyl cysteine (NAC), and aged garlic. In addition, some foods, such as pomegranate, broccoli, green tea, or green tea extract (EGCG) are effective. Two other natural proprietary compounds called NEO 40 and Arterosil will improve nitric oxide levels, dilate the coronary arteries, and stabilize and reduce plaque (Arterosil). The combination of many of these will stabilize plaque, reduce plaque volume, reduce the lipid core, and decrease CAC.
Intravascular imaging in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Vijayakumar Subban, Suma M Victor
Vulnerable plaque is one which predisposes the patient to clinical events by rapid progression or thrombosis. It is characterised by expansive remodelling, large lipid content/necrotic core, thin fibrous cap (<65 μ), inflammation, spotty calcification, neoangiogenesis and intraplaque haemorrhage. Detection of such plaques may help in implementing treatment strategies that reduce progression to ACS [5].
Cardiovascular Health Informatics Computing Powered by Unobtrusive Sensing Computing, Medical Image Computing, and Information Fusion Analysis
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Chengjin Yu, Xiuquan Du, Yanping Zhang, Heye Zhang
Developing high resolution biomedical imaging is crucial for early prevention of CVD. Atherosclerosis is the main cause of acute cardiovascular disease [60]. The development of atherosclerosis will lead to unstable atherosclerotic plaques or vulnerable plaque, which is characterized as active inflammation, a thin fibrous cap with a large lipid core, erosion or fissure of the plaque surface, intra-plaque hemorrhage, and superficial calcified nodules [60][61]. Vulnerable plaque will narrow blood vessels or even occlude the vessel, resulting in the block of blood flow to vital organs, such as the heart and the brain. If the treatment of atherosclerosis is delayed, subsequently the rupture of vulnerable plaque will cause acute coronary death or stroke [60]. In addition, other kinds of cardiac diseases, such as myocarditis, electrophysiological disorders, valvular heart disease, and other cardiomyopathies (hypertrophic, dilated, or restrictive) are often related to vulnerable myocardium, and vulnerable plaques, which have a high likelihood of thrombotic complications and rapid progression, and so should be diagnosed and treated as early as possible [25][10].
Achieving coronary plaque regression: a decades-long battle against coronary artery disease
Published in Expert Review of Cardiovascular Therapy, 2022
Venkat S. Manubolu, Matthew J. Budoff
Technological advancements in cardiovascular imaging, including both invasive and noninvasive modalities, have increased our understanding of the biology of coronary atherosclerosis, plaque development, and progression to event-prone plaques. Traditionally invasive angiography was used in early 1990´s to evaluate the effect of statins on plaque progression, which was measured in terms of changes in luminal diameter and percentage stenosis. This was replaced by the invention of intravascular ultrasound (IVUS) [25,26]. Several clinical trials conducted in the early 2000s utilized gray scale IVUS, which allowed transmural imaging of the complete artery wall and enabled both early diagnosis of atherosclerosis and accurate measurement of plaque volumes. Subsequently, the development of novel IVUS-based post-processing techniques such as virtual histology IVUS (VH-IVUS), iMAP-IVUS, and Integrated Backscatter IVUS improved assessment of coronary plaque composition and enabled us to follow changes in plaque overtime. Intravascular optical coherence tomography (OCT) is another intracoronary imaging technique that uses emission and reflection of near-infrared light to produce cross-sectional images of coronary arteries in order to evaluate the plaque characteristics. OCT has approximately 10-fold greater resolution than ultrasound-based techniques with a resolution of 4–20 um. This makes it an ideal imaging modality to identify the thin fibrous cap (defined as <65 um) in patients with thin-cap fibroatheroma. This imaging modality has primarily been used to evaluate vulnerable plaque characteristics.
Current perspectives on bioresorbable scaffolds in coronary intervention and other fields
Published in Expert Review of Medical Devices, 2021
Xinlei Wu, Sijing Wu, Hideyuki Kawashima, Hironori Hara, Masafumi Ono, Chao Gao, Rutao Wang, Mattia Lunardi, Faisal Sharif, William Wijns, Patrick W. Serruys, Yoshinobu Onuma
More recently, the results from the PROSPECT ABSORB trial were presented at TCT 2020 [54]. The study was designed to evaluate the effects of vulnerable plaque treatment with ABSORB BVS. It included patients with ACS who underwent successful PCI in the PROSPECT II natural history study [55]. NIRS-IVUS imaging was performed in all three coronary arteries. Non-target, non-flow-limiting lesions (i.e. angiographic DS<70%, IVUS plaque burden≥65%) were identified and randomly assigned to two strategies: ABSORB BVS implantation plus medical treatment vs. medical treatment alone. One-hundred sixty-seven of 182 patients (91.8%) were repeated with angiography and NIRS-IVUS imaging at 25-month follow-up, and showed that the MLA at the original site was increased from 3.2 to 6.9 mm2 in the ABSORB BVS arm, but unchanged in patients treated with medical therapy (p < 0.001). The primary safety endpoint of TLF (i.e. composite of cardiac death, target vessel MI, or clinically driven TLR) occurred in 4.3% of ABSORB BVS arm and 4.5% of medical treatment arm (p = 0.96). After a median follow-up of 4 years, lesion related MACE occurred in 4.3% of the ABSORB BVS arm and 10.7% of the medical treatment arm (p = 0.12).
Added value of aortic pulse wave velocity index for the detection of coronary heart disease by elective coronary angiography
Published in Blood Pressure, 2019
Alexandre Vallée, Yi Zhang, Athanase Protogerou, Michel E. Safar, Jacques Blacher
It remains unclear if percutaneous angioplasty of severe coronary artery stenosis, in association with optimal medical therapy, improves outcomes in patients with stable CHD [35]. The concept of vulnerable plaque is one of the main precursors of acute coronary syndrome [36]. Nevertheless, the evaluation of coronary stenosis severity during CAG remains inadequate to predict the location or the time of a future myocardial infarction [37]. Pending further methods to identify those coronary plaques that are on the evolution toward a vulnerable state for targeted therapeutic interventions, the pan arterial approach could serve as an aid to identify at-risk patients. The degree of pulsatile stress, which is closely related to aortic stiffness, appears to be associated with risk of plaque disruption [38]. Central pulsatility is considered the main powerful hemodynamic predictor of CV risk in coronary patients [39]. The aortic PWV index may therefore represent a candidate marker of arterial damage that may be indicative of the presence of vulnerable plaque prone to rupture.