Читать книгу Interventional Cardiology - Группа авторов - Страница 18

Daisuke Shishikura, Yanti Octavia, Umair Hayat, Vikas Thondapu, and Peter Barlis

The importance of atherosclerosis and its clinical consequences are well known as the leading cause of vascular disease worldwide [1]. The aetiology of atherosclerosis is multifactorial, and it affects various regions of the circulation preferentially resulting in heart attack, stroke, and peripheral vascular disease [2]. Atherosclerosis is considered a chronic immunoinflammatory disease fuelled by lipid, which typically occurs over many years [3]. The growth of atherosclerotic plaques does not occur in a smooth, linear fashion but discontinuously, with a stage of relative ‘silent’ period, punctuated by a period of rapid evolution which manifests clinically [4].

The formation of atherosclerosis is a complex process involving the interaction of plasma lipids with the vascular wall and immune cells [5]. Multiple independent pathways of evidence pinpoint inflammation as a centre regulatory process that connects various risk factors for atherosclerosis and its complications with altered arterial biology [6]. Abundant research from experimental and clinical studies have lent strong support to unravel the complex pathogenesis and find targeted management of the atherosclerotic disease; this entity still represents an ongoing challenge in clinical practice. This chapter will review the multifaceted pathology of atherosclerosis leading to plaque progression and destabilisation, with a recent update in coronary imaging modalities and novel developments in computer modelling as promising tools to help improve the understanding of cardiovascular diseases.