Significance of Intra-plaque Hemorrhage for the Development of High-Risk Vulnerable Plaque: Current Understanding from Basic to Clinical Points of View

作者：Atsushi Sakamoto, Kenichiro Suwa, Rika Kawakami, Alexandra V. Finn, Alexandra V. Finn, Yuichiro Maekawa, Renu Virmani, Aloke Virmani Finn, Aloke Virmani Finn · 发表于：International Journal of Molecular Sciences · 年份：2023 · DOI：10.3390/ijms241713298 · 被引用次数：32 · 研究领域：Coronary Interventions and Diagnostics、Angiogenesis and VEGF in Cancer、Atherosclerosis and Cardiovascular Diseases

Acute coronary syndromes due to atherosclerotic coronary artery disease are a leading cause of morbidity and mortality worldwide. Intra-plaque hemorrhage (IPH), caused by disruption of intra-plaque leaky microvessels, is one of the major contributors of plaque progression, causing a sudden increase in plaque volume and eventually plaque destabilization. IPH and its healing processes are highly complex biological events that involve interactions between multiple types of cells in the plaque, including erythrocyte, macrophages, vascular endothelial cells and vascular smooth muscle cells. Recent investigations have unveiled detailed molecular mechanisms by which IPH leads the development of high-risk "vulnerable" plaque. Current advances in clinical diagnostic imaging modalities, such as magnetic resonance image and intra-coronary optical coherence tomography, increasingly allow us to identify IPH in vivo. To date, retrospective and prospective clinical trials have revealed the significance of IPH as detected by various imaging modalities as a reliable prognostic indicator of high-risk plaque. In this review article, we discuss recent advances in our understanding for the significance of IPH on the development of high-risk plaque from basic to clinical points of view.