1.The Role of Carotid Ultrasound for Cardiovascular Risk Stratification beyond Traditional Risk Factors.
Yonsei Medical Journal 2014;55(3):551-557
Primary prevention and early detection of cardiovascular disease is important, as it is the leading cause of death throughout world. Risk stratification algorithms, such as Framingham Risk Score and European Systematic Coronary Risk Evaluation, that utilize a combination of various traditional risk factors have been developed to improve primary prevention. However, the accuracy of these algorithms for screening high risk patients is moderate at best. Accordingly, the use of biomarkers or imaging studies may improve risk stratification. Carotid ultrasound, which measures both carotid intima-media thichkness (cIMT) and carotid plaque, is useful in detecting the degree of subclinical carotid atherosclerosis, and has the advantage of being noninvasive and safe. Several large epidemiologic studies have indicated that cIMT and carotid plaque are closely related with other cardiovascular risk factors and may be useful for risk reclassification in subjects deemed to be at intermediate risk by traditional risk scores. Moreover, recent clinical guidelines for management of hypertension or dyslipidemia highlight the usefulness of cIMT in high risk patients. In this article, we review evidence for the usefulness of measurement of cIMT and carotid plaque for cardiovascular risk stratification.
Cardiovascular Diseases/*pathology/*ultrasonography
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*Carotid Intima-Media Thickness
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Humans
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Plaque, Atherosclerotic/*pathology/*ultrasonography
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Risk Factors
2.Cardiovascular Molecular Imaging with Contrast Ultrasound: Principles and Applications.
Chi Young SHIM ; Jonathan R LINDNER
Korean Circulation Journal 2014;44(1):1-9
Methods for imaging the molecular or cellular profile of tissue are being developed for all forms of non-invasive cardiovascular imaging. It is thought that these technologies will potentially improve patient outcomes by allowing diagnosis of disease at an early-stage, monitoring disease progression, providing important information on patient risk, and for tailoring therapy to the molecular basis of disease. Molecular imaging is also already assuming an important role in science by providing a better understanding of the molecular basis of cardiovascular pathology, for assessing response to new therapies, and for rapidly optimizing new or established therapies. Ultrasound-based molecular imaging is one of these new approaches. Contrast-enhanced ultrasound molecular imaging relies on the detection of novel site-targeted microbubbles (MB) or other acoustically active particles which are administered by intravenous injection, circulate throughout the vascular compartment, and are then retained and imaged within regions of disease by ligand-directed binding. The technique is thought to be advantageous in practical terms of cost, time, and ease of use. The aim of this review is to discuss the molecular participants of cardiovascular disease that have been targeted for ultrasound imaging, general features of site-targeted MB, imaging protocols, and potential roles of ultrasound molecular imaging in cardiovascular research and clinical medicine.
Cardiovascular Diseases
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Clinical Medicine
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Diagnosis
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Disease Progression
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Humans
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Injections, Intravenous
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Methods
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Microbubbles
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Molecular Imaging*
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Pathology
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Ultrasonography*
3.Multiple cardiovascular complications in a patient with Behcet's disease.
Ji Eun CHANG ; You Hyun LEE ; Jisoo LEE
The Korean Journal of Internal Medicine 2008;23(2):100-102
Arterial and cardiac involvement of Behcet's disease is a rare but life threatening complication. The rupture of an arterial aneurysm might result in sudden death. We report a 54-year-old man with an established diagnosis of Behcet's disease who presented with multiple cardiovascular complications that eventually lead to his death. He presented with extensive venous occlusions, and sequentially developed right ventricular thrombosis with multiple pulmonary thromboembolisms, and a pulmonary artery aneurysm. We report this unusual sequence of cardiovascular complications in a patient with Behcet's disease.
Aneurysm, Dissecting/*etiology
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Behcet Syndrome/*complications
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Cardiovascular Diseases/diagnosis/*etiology/ultrasonography
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Fatal Outcome
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Hemoptysis
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Humans
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Male
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Middle Aged
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Pulmonary Artery/*pathology
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Pulmonary Embolism/*etiology
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Risk Factors
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Rupture/etiology
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Tomography, X-Ray Computed