JACC. Cardiovascular imaging最新文献

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Impact of Cumulative Sleep Duration on Cardiac Structural Remodeling in Asymptomatic Adolescents. 累积睡眠时间对无症状青少年心脏结构重构的影响。
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-05 DOI: 10.1016/j.jcmg.2025.05.006
Carlos Real, Rocío Párraga, Jesús Martínez-Gómez, María Beneito-Dura, Ernesto González-Calvo, Raquel Diaz-Munoz, Paula Fernández-Acín, Eva Gutierrez-Ortiz, Miriam Garcia-Cocera, Javier Sánchez-González, Gonzalo Pizarro, Inés García-Lunar, Carlos Galán-Arriola, Juan Miguel Fernández-Alvira, Mercedes De Miguel, Amaya de Cos-Gandoy, Patricia Bodega, Leopoldo Pérez de Isla, Antonio Fernandez-Ortiz, Borja Ibáñez, Gloria Santos-Beneit, Valentín Fuster, Rodrigo Fernández-Jiménez
{"title":"Impact of Cumulative Sleep Duration on Cardiac Structural Remodeling in Asymptomatic Adolescents.","authors":"Carlos Real, Rocío Párraga, Jesús Martínez-Gómez, María Beneito-Dura, Ernesto González-Calvo, Raquel Diaz-Munoz, Paula Fernández-Acín, Eva Gutierrez-Ortiz, Miriam Garcia-Cocera, Javier Sánchez-González, Gonzalo Pizarro, Inés García-Lunar, Carlos Galán-Arriola, Juan Miguel Fernández-Alvira, Mercedes De Miguel, Amaya de Cos-Gandoy, Patricia Bodega, Leopoldo Pérez de Isla, Antonio Fernandez-Ortiz, Borja Ibáñez, Gloria Santos-Beneit, Valentín Fuster, Rodrigo Fernández-Jiménez","doi":"10.1016/j.jcmg.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.006","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Association Between Cardiac Symptoms and Coronary Plaque: An ADVANCE Substudy. 心脏症状与冠状动脉斑块之间的关系:一项ADVANCE亚研究
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-03 DOI: 10.1016/j.jcmg.2025.05.002
Ruurt A Jukema, Philipp Blanke, John K Khoo, Georgios Tzimas, Aaisha Ferkh, Timothy Fairbairn, Koen Nieman, Manesh Patel, Bjarne L Nørgaard, Jonathon A Leipsic
{"title":"The Association Between Cardiac Symptoms and Coronary Plaque: An ADVANCE Substudy.","authors":"Ruurt A Jukema, Philipp Blanke, John K Khoo, Georgios Tzimas, Aaisha Ferkh, Timothy Fairbairn, Koen Nieman, Manesh Patel, Bjarne L Nørgaard, Jonathon A Leipsic","doi":"10.1016/j.jcmg.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.002","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Polymorphic Size of Lipoprotein(a) and Structural Bioprosthetic Valve Degeneration. 脂蛋白多态性大小(a)与结构性生物瓣膜变性。
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-02 DOI: 10.1016/j.jcmg.2025.05.007
Romain Capoulade, Mikaël Croyal, Thomas Senage, Guillaume Guimbretière, Cédric Le May, Arsênio Rodrigues Oliveira, Maxime Carpentier, Nicolas Piriou, Imen Fellah-Hebia, Cristina Costa, Marta Vadori, Manuel Galiñanes, Rafael Manez, Jean-Michel Serfaty, Jean-Paul Soulillou, Emanuele Cozzi, Vered Padler-Karavani, Jean-Christian Roussel, Bertrand Cariou, Thierry Le Tourneau
{"title":"Polymorphic Size of Lipoprotein(a) and Structural Bioprosthetic Valve Degeneration.","authors":"Romain Capoulade, Mikaël Croyal, Thomas Senage, Guillaume Guimbretière, Cédric Le May, Arsênio Rodrigues Oliveira, Maxime Carpentier, Nicolas Piriou, Imen Fellah-Hebia, Cristina Costa, Marta Vadori, Manuel Galiñanes, Rafael Manez, Jean-Michel Serfaty, Jean-Paul Soulillou, Emanuele Cozzi, Vered Padler-Karavani, Jean-Christian Roussel, Bertrand Cariou, Thierry Le Tourneau","doi":"10.1016/j.jcmg.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Full issue PDF 完整版PDF
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/S1936-878X(25)00229-3
{"title":"Full issue PDF","authors":"","doi":"10.1016/S1936-878X(25)00229-3","DOIUrl":"10.1016/S1936-878X(25)00229-3","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages I-CXXIX"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association Between Physiological Significance and Vulnerable Plaque Characteristics in Patients With Myocardial Infarction 心肌梗死患者的生理意义与易损斑块特征之间的关系:一项前瞻性II亚研究。
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2024.11.002
Ketina Arslani MD , Thomas Engstrøm MD, PhD , Michael Maeng MD, PhD , Lars Kjøller-Hansen DMSc , Akiko Maehara MD , Zhipeng Zhou MA , Ori Ben-Yehuda MD , Hans Erik Bøtker MD, PhD, DMSc , Mitsuaki Matsumura BS , Gary S. Mintz MD , Ole Fröbert MD, PhD , Jonas Persson MD, PhD , Rune Wiseth MD, PhD , Alf I. Larsen MD, PhD , Lisette O. Jensen MD, PhD , Jan E. Nordrehaug MD, PhD , Øyvind Bleie MD, PhD , Elmir Omerovic MD, PhD , Claes Held MD, PhD , Stefan K. James MD, PhD , Gregg W. Stone MD
{"title":"Association Between Physiological Significance and Vulnerable Plaque Characteristics in Patients With Myocardial Infarction","authors":"Ketina Arslani MD ,&nbsp;Thomas Engstrøm MD, PhD ,&nbsp;Michael Maeng MD, PhD ,&nbsp;Lars Kjøller-Hansen DMSc ,&nbsp;Akiko Maehara MD ,&nbsp;Zhipeng Zhou MA ,&nbsp;Ori Ben-Yehuda MD ,&nbsp;Hans Erik Bøtker MD, PhD, DMSc ,&nbsp;Mitsuaki Matsumura BS ,&nbsp;Gary S. Mintz MD ,&nbsp;Ole Fröbert MD, PhD ,&nbsp;Jonas Persson MD, PhD ,&nbsp;Rune Wiseth MD, PhD ,&nbsp;Alf I. Larsen MD, PhD ,&nbsp;Lisette O. Jensen MD, PhD ,&nbsp;Jan E. Nordrehaug MD, PhD ,&nbsp;Øyvind Bleie MD, PhD ,&nbsp;Elmir Omerovic MD, PhD ,&nbsp;Claes Held MD, PhD ,&nbsp;Stefan K. James MD, PhD ,&nbsp;Gregg W. Stone MD","doi":"10.1016/j.jcmg.2024.11.002","DOIUrl":"10.1016/j.jcmg.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Hemodynamically obstructive coronary plaques may contain more vulnerable plaque characteristics than nonobstructive lesions.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess whether pressure-wire–based physiologic indices in nonculprit lesions are associated with vulnerable plaque characteristics.</div></div><div><h3>Methods</h3><div>In the PROSPECT II study, patients with recent myocardial infarction underwent coronary angiography and culprit lesion percutaneous coronary intervention plus combined near-infrared spectroscopy and intravascular ultrasound assessment of all 3 coronary arteries. Instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements were performed in intermediate lesions with angiographic stenosis &gt;40%.</div></div><div><h3>Results</h3><div>Among 898 patients, 319 angiographically intermediate lesions in 275 patients had matched intravascular ultrasound/near-infrared spectroscopy and FFR/iFR measurements; 96 (30.1%) lesions were physiologically significant (FFR ≤0.80 or iFR ≤0.89) and 223 (69.9%) were not. Physiologically significant lesions, compared with those that were not, more likely had a minimal lumen area ≤4.0 mm<sup>2</sup> (96.9% vs 83.9%), plaque burden ≥70% (92.7% vs 71.3%) and maximum lipid core burden index in any 4 mm segment of the lesion ≥324.7 (57.0% vs 45.4%). By multivariable analysis, lesion location in the left anterior descending artery, small minimal lumen area, and larger plaque burden were independently associated with physiologic significance, whereas maximum lipid core burden index in any 4 mm segment of the lesion was not.</div></div><div><h3>Conclusions</h3><div>In patients with recent myocardial infarction, angiographically intermediate but physiologically significant coronary lesions were more likely to have high-risk vulnerable plaque features compared with nonphysiologically significant stenoses. However, coronary lesions without physiological significance also had a moderate-to-high prevalence of high-risk plaque characteristics, which may explain the residual risk associated with conservative noninterventional management of these lesions. (Providing Regional Observations to Study Predictors of Events in the Coronary Tree II [PROSPECT II]; <span><span>NCT02171065</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 696-706"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Vulnerable Plaque Imaging PREVENT Cardiovascular Events? 易损斑块成像能预防心血管事件吗?
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2024.12.009
Stephen J. Nicholls MBBS, PhD, Adam J. Nelson MBBS, PhD
{"title":"Can Vulnerable Plaque Imaging PREVENT Cardiovascular Events?","authors":"Stephen J. Nicholls MBBS, PhD,&nbsp;Adam J. Nelson MBBS, PhD","doi":"10.1016/j.jcmg.2024.12.009","DOIUrl":"10.1016/j.jcmg.2024.12.009","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 707-708"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Echocardiographic Report Card 5 Years After Aortic Valve Replacement 主动脉瓣置换术后5年超声心动图报告卡:TAVR仍获得高分。
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2025.03.006
Brian R. Lindman MD, MSc , Bassim El-Sabawi MD
{"title":"Echocardiographic Report Card 5 Years After Aortic Valve Replacement","authors":"Brian R. Lindman MD, MSc ,&nbsp;Bassim El-Sabawi MD","doi":"10.1016/j.jcmg.2025.03.006","DOIUrl":"10.1016/j.jcmg.2025.03.006","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 641-643"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global Practices in Cardiac Imaging for Cardiac Sarcoidosis 心脏结节病的全球心脏成像实践
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2025.02.010
Tahir S. Kafil MD , Manuel L. Ribeiro Neto MD , Marc A. Judson MD , Leslie T. Cooper Jr. MD , Jordana Kron MD , Jan C. Grutters MD , David H. Birnie MD, MBChB , Ronald Witteles MD , Emer Joyce MD, PhD , Edward J. Miller MD, PhD , Amit S. Patel MD , Daniel A. Culver DO , Christine L. Jellis MD, PhD
{"title":"Global Practices in Cardiac Imaging for Cardiac Sarcoidosis","authors":"Tahir S. Kafil MD ,&nbsp;Manuel L. Ribeiro Neto MD ,&nbsp;Marc A. Judson MD ,&nbsp;Leslie T. Cooper Jr. MD ,&nbsp;Jordana Kron MD ,&nbsp;Jan C. Grutters MD ,&nbsp;David H. Birnie MD, MBChB ,&nbsp;Ronald Witteles MD ,&nbsp;Emer Joyce MD, PhD ,&nbsp;Edward J. Miller MD, PhD ,&nbsp;Amit S. Patel MD ,&nbsp;Daniel A. Culver DO ,&nbsp;Christine L. Jellis MD, PhD","doi":"10.1016/j.jcmg.2025.02.010","DOIUrl":"10.1016/j.jcmg.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac imaging is a cornerstone in the initial diagnosis, management, and follow-up of cardiac sarcoidosis. However, ordering thresholds, access, and follow-up imaging vary across the globe.</div></div><div><h3>Objectives</h3><div>A Delphi study was conducted to define areas of consensus and areas requiring further study in the use of cardiac imaging in suspected or established cardiac sarcoidosis.</div></div><div><h3>Methods</h3><div>An international, multidisciplinary panel of experts in cardiac sarcoidosis completed a modified 2-round Delphi study. The study evaluated clinical decision making regarding the use of cardiac imaging, including indication thresholds, interpretation, and interval follow-up imaging. Consensus was defined a priori as ≥70% agreement or disagreement.</div></div><div><h3>Results</h3><div>A total of 89 experts in cardiac sarcoidosis (89 in round 1 and 75 in round 2) participated, representing 61 centers in 13 countries. Consensus was reached on 22 of 46 items (48%) in round 1 and 21 of 29 items (72%) in round 2. There was a low threshold to order advanced cardiac imaging for new rhythm abnormalities or ventricular dysfunction detected on echocardiography in patients with established extracardiac sarcoidosis. <sup>18</sup>F-fluorodeoxyglucose (FDG) positron emission tomography was an important co-primary modality with cardiac magnetic resonance (CMR) for initial diagnosis. If CMR was the first test, there was consensus to proceed to FDG–positron emission tomography after any abnormal CMR result or even after normal CMR result in the setting of moderate or high pretest probability for cardiac sarcoidosis. There was consensus that late gadolinium enhancement quantification was important, but there was no consensus on the threshold of risk or on how best to quantify late gadolinium enhancement. Similarly, reduction in FDG uptake was an important factor in guiding treatment response, but there was no consensus on how to best quantify FDG uptake or what constituted an adequate radiographic response.</div></div><div><h3>Conclusions</h3><div>Several consensus areas for cardiac imaging in suspected and established cardiac sarcoidosis were identified. This consensus study identified areas of priority for future prospective, controlled, multicenter research studies.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 679-692"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial Differences in Cardiovascular Mortality Among Patients in the Coronary Artery Calcium Consortium 冠状动脉钙化联盟患者心血管死亡率的种族差异
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2025.04.005
Quinn Capers IV MD
{"title":"Racial Differences in Cardiovascular Mortality Among Patients in the Coronary Artery Calcium Consortium","authors":"Quinn Capers IV MD","doi":"10.1016/j.jcmg.2025.04.005","DOIUrl":"10.1016/j.jcmg.2025.04.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 676-678"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vulnerable or High-Risk Plaque 易损或高危斑块:A JACC:心血管影像学立场声明。
IF 12.8 1区 医学
JACC. Cardiovascular imaging Pub Date : 2025-06-01 DOI: 10.1016/j.jcmg.2024.12.004
Rocco Vergallo MD, PhD , Seung-Jung Park MD, PhD , Gregg W. Stone MD , David Erlinge MD, PhD , Italo Porto MD, PhD , Ron Waksman MD , Gary S. Mintz MD , Fabrizio D’Ascenzo MD, PhD , Sara Seitun MD , Luca Saba MD , Rozemarijn Vliegenthart MD, PhD , Fernando Alfonso MD , Armin Arbab-Zadeh MD, PhD, MPH , Peter Libby MD , Marcelo F. Di Carli MD , James E. Muller MD , Gerald Maurer MD , Robert J. Gropler MD , Y.S. Chandrashekhar MD , Eugene Braunwald MD , Ik-Kyung Jang MD, PhD
{"title":"Vulnerable or High-Risk Plaque","authors":"Rocco Vergallo MD, PhD ,&nbsp;Seung-Jung Park MD, PhD ,&nbsp;Gregg W. Stone MD ,&nbsp;David Erlinge MD, PhD ,&nbsp;Italo Porto MD, PhD ,&nbsp;Ron Waksman MD ,&nbsp;Gary S. Mintz MD ,&nbsp;Fabrizio D’Ascenzo MD, PhD ,&nbsp;Sara Seitun MD ,&nbsp;Luca Saba MD ,&nbsp;Rozemarijn Vliegenthart MD, PhD ,&nbsp;Fernando Alfonso MD ,&nbsp;Armin Arbab-Zadeh MD, PhD, MPH ,&nbsp;Peter Libby MD ,&nbsp;Marcelo F. Di Carli MD ,&nbsp;James E. Muller MD ,&nbsp;Gerald Maurer MD ,&nbsp;Robert J. Gropler MD ,&nbsp;Y.S. Chandrashekhar MD ,&nbsp;Eugene Braunwald MD ,&nbsp;Ik-Kyung Jang MD, PhD","doi":"10.1016/j.jcmg.2024.12.004","DOIUrl":"10.1016/j.jcmg.2024.12.004","url":null,"abstract":"<div><div>The concept of high-risk plaque emerged from pathologic and epidemiologic studies 3 decades ago that demonstrated plaque rupture with thrombosis as the predominant mechanism of acute coronary syndrome and sudden cardiac death. Thin-cap fibroatheroma, a plaque with a large lipidic core covered by a thin fibrous cap, is the prototype of the rupture-prone plaque and has been traditionally defined as “vulnerable plaque.” Although knowledge on the pathophysiology of plaque instability continues to grow, the risk profile of our patients has shifted and the character of atherosclerotic disease has evolved, partly because of widespread use of lipid-lowering therapies and other preventive measures. In vivo intracoronary imaging studies indicate that superficial erosion causes up to 40% of acute coronary syndromes. This changing landscape calls for broader perspective, expanding the concept of high-risk plaque to the precursors of all major substrates of coronary thrombosis beyond plaque rupture. Other factors to take into consideration include dynamic changes in plaque composition, the importance of plaque burden, inflammatory activation (both local and systemic), healing mechanisms, regional hemodynamic pattern, properties of the fluid phase of blood, and the amount of myocardium at risk subtended by a lesion. Rather than the traditional focus limited to the thin-cap fibroatheroma, the authors advocate a more comprehensive approach that considers both morphologic features and biological activity of plaques and blood. This position paper highlights the challenges to the usual concept of high-risk plaque, proposes a broader definition, and analyzes its key morphologic features, the technological progress of plaque imaging (particularly using intracoronary imaging techniques), advances in pharmacologic therapies for plaque regression and stabilization, and the feasibility and efficacy of focal interventional treatments including preemptive plaque sealing.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 6","pages":"Pages 709-740"},"PeriodicalIF":12.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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