Work

Does 3D volumetric carotid plaque imaging by cardiovascular MRI solve the mystery of the 'percent stenosis paradox'?

Year: 2009

Type: article

Abstract: Aggressive pharmacologic, dietary and exercise strategies have been employed in recent years to dramatically lower incidence of CAD as evidenced by striking reductions in MI and CVA and other cardiovascular complications. Yet, when examined at the pathologic source, namely the arterial lumen, little if any changes are seen. Typically, luminal % stenosis changes are nominal after aggressive statin intervention, often <5%, yet translate clinically into substantial reductions in morbidity and mortality. The explanation for this dichotomy remains unclear. Recently, we and others have noted that morphologic characteristics of plaque composition help to explain the apparent paradox of improved clinical events despite no or minimal reduction in % stenosis with statins. In that CMR can distinguish underlying features that determine plaque 'vulnerability', we sought to define the role of composition vs. %stenosis.

Source: Journal of Cardiovascular Magnetic Resonance

DOI: 10.1186/1532-429x-11-s1-p22