About this Research Topic

Background

Atherosclerosis is a progressive, chronic inflammatory disorder and the primary disease of cardiovascular disease. Ischemic heart disease and stroke accounted for nearly 15 million deaths a year worldwide, which were the top two leading causes of death. Identification of significant luminal narrowing in vessels with angiography has been the gold standard diagnosis of obstructive artery stenosis for decades. However, the majority of cases of myocardial infarction and sudden cardiac death result from atherosclerotic plaque complications (i.e., erosion, rupture, and thrombosis). Secondary, the mortality of ischemic heart disease is due to progression of heart failure and fatal arrhythmia.

It is important to evaluate metabolic status of heart and vessels beyond stenosis. The features of high-risk plaques, including large necrotic ischemic core, micro-calcification, neovascularization and abundance of inflammatory cells, had an incremental prediction of events. We also need advanced imaging tools that can represent the pathophysiological metabolic status of the ischemic heart under the transitions recovering back to health or moving forward to severe heart failure. Numerous blood-based biomarkers are associated with increased cardiovascular risk. Biomarkers indicating imminent destabilization and remodelling may also help to evaluate the condition of plaque and transitional status of heart. Therefore, we needed to refine other cardiac risk assessment tools, including imaging and laboratory test to identify vulnerable plaques and at-risk individuals before cardiac events. We assumed that early detection would ameliorate the burden of cardiovascular disease.

Our ultimate goal is to decrease the disease burden of cardiovascular disease, including myocardial infarction, sudden cardiac death, heart failure and stroke. Our secondary goal is to refine proper cardiac risk assessment tools to identify at-risk plaques and individuals and discover the image tools for tracing the key molecular changes that determined heart failure prognosis or the self-repair/regeneration outcome after cardiovascular injury.

In order to do this, we want to understand the cellular and molecular mechanism of atherosclerosis, thoroughly. We want to investigate and develop new molecular imaging tracers for better identification and imaging quality. Our primary goal is to find suitable molecules, imaging modalities, animal and human imaging protocols and probable combination of both anatomical and functional imaging to identify and evaluate the risk of atherosclerotic plaque and metabolic status of heart.

Topics of interest are as below:
1) Investigate the cellular and molecular mechanism of atherosclerosis, especially micro-calcification, necrosis, hypoxia, neovascularization, inflammation, and other possible novel mechanisms.
2) Investigation of metabolic switch and the metabolomic alteration during atherosclerosis and heart failure progression.
3) Investigate the role of anatomical imaging including computed tomography and magnetic resonance imaging in imaging atherosclerosis and their uses in clinical practice.
4) Application of magnetic resonance imaging in both functional and molecular aspect for diagnosis, evaluation of severity of atherosclerosis and further investigation.
5) Application of available molecular tracers, animal models, human imaging protocol for studying atherosclerosis and pathophysiological transition of heart failure.
6) Demonstrate the causal relationship between image biomarkers and pathophysiological signalling pathways in progression of atherosclerosis and ischemic heart disease and the potential to prognosis prediction.
7) Investigate the use of multi-modality imaging for evaluating the risk stratification before therapy, therapeutic response, and therapeutic drug development.
8) Development of novel molecular tracers for imaging atherosclerosis and metabolic status of heart.

Keywords: atherosclerosis, cardiovascular metabolism, positron emission tomography, computed tomography, magnetic resonance imaging

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