Magnetic resonance imaging Protocol for the characterization of Atherosclerotic Plaque by using Vascular cell Adhesion Molecule-1 and Apoptosis- Targeted ultrasmall superparamagnetic iron Oxide derivatives

According to the World Health Organization, cardiovascular diseases are the deadliest in the world, 17.1 million deaths per year are being caused by acute cardiovascular events (ACE) (ie, myocardial infarction and cerebral vascular accident). The lowand middleincome countries contribute to over 80% of cardiovascular disease deaths, which occur almost equally in men and women. In women, the cardiovascular risk is particularly high after menopause. The identification and stratification of patients at risk for future ACE triggered by progressive atherosclerotic disease hence became a priority for medicine. In this context, the definition of atherosclerotic plaque biomarkers with strong prognostic and diagnostic value for patient stratification is a prerequisite for the development and validation of plaque stabilizing therapies. The term vulnerable atherosclerotic plaque was introduced by Muller et al 2 decades ago, aiming to define those plaques that are prone to rupture and responsible for ACE. The precise mechanisms leading to plaque rupture remain to be elucidated, mainly because of the lack of an ideal animal model that could accurately reproduce human pathology. It has been established that ACE are not necessarily the result of slowly progressing luminal narrowing (ie, arterial stenosis) consequent to plaque growth, but are rather produced by the acute disruption (rupture or erosion) of atherosclerotic plaque followed by exposure of thrombogenic plaque components to the bloodstream and the subsequent thrombus formation. The latter triggers ACE by enhancing the degree of luminal stenosis or by producing distal arterial embolization. The terms unstable plaque or highrisk plaque were introduced during the Meeting on Vulnerable Plaque in 2003, when these thromboseprone plaques were described as containing a large thrombogenic lipid core or a calcified nodule covered by a fragile fibrous cap or a dysfunctional or interrupted endothelium. The development of optimal diagnosis and treatment strategies is tributary to the comprehension of molecular mechanisms development of a Magnetic resonance imaging Protocol for the characterization of Atherosclerotic Plaque by using Vascular cell Adhesion Molecule-1 and ApoptosisTargeted ultrasmall superparamagnetic iron Oxide derivatives