American Journal of Internal Medicine
Volume 3, Issue 4, July 2015, Pages: 165-179
Received: May 30, 2015;
Accepted: Jun. 22, 2015;
Published: Jul. 4, 2015
Views 5100 Downloads 110
Faruk Erzengin, Department of Cardiology, Previous Dean, University of Istanbul, Istanbul Medical Faculty, Istanbul, Turkey
Evren Bursuk, Program of Biomedical Technologies, University of Istanbul, Vocational School of Technical Sciences, Istanbul, Turkey
The formation of atherosclerotic and calcified plaques begins and develops not only below the endothelium (intimae), but also in the adventitia. Multislice Computed Tomography (MSCT= Cardiac CT) is a very important tool for the diagnosis and treatment of the atherosclerotic calcification in the coronary arteries. Due to rapid improvement in technology, MSCT techniques have also progressed quickly, leading to the development of the 640 slice MSCT. Following the development of this advanced non-invasive technology (640 slice), came up from stage 4C than to the 1A level. Compared to older technologies (e.g. 64, 128 and 320 slice MSCT), the 640 slice MSCT provides various advantages such as higher lateral resolution, lower radiation, and the ability to obtain results more rapidly and accurately. We also introduce a special four cases diagnosed by MSCT, two of them silent ischemia, one of them acute asymptomatic myocardial infarction, and the last one angina pectoris with myocardial bridge(respectively, a 88 year old man, 62 year old man, 66 year old man and 53 year old woman). It was observed that a new innovative combined drug (polypill) is able to prevent the formation of atherosclerotic and calcified plaque of arteries, and to regress pre-existing ones.
Ct Cardiac Imaging for Evaluation and Treatment of Ischemic Heart Disease, American Journal of Internal Medicine.
Vol. 3, No. 4,
2015, pp. 165-179.
Fuster V. Epidemic of cardiovascular disease and stroke: The three main challenges. Circulation 1999; 99:1132-1137.
Fuster V. Atherosclerosis, thrombosis, and vascular biology. Cecil Textbook of Medicine, Ed: Lee Goldman, Dennis Ausiello, 22nd Edition, Saunders, Philadelphia, Philadelphia, Pages 383-400, 2004.
Lipid Study Group. Prevention of cardiovascular events and death with pravastatin in patient with coronary heart disease and abroad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Stud Group. N Eng J Me 1998; 339:1349.
Falk E, FusterV. Atherogenesis and its determinants. Hurst’s The Heart, Ed: Valentin Fuster, R. Wayne Alexander, Robert A. O’Rourke, Robert Roberts, Spencer B. King III, Hein J.J.Wellens. 10th edition, McGraw-Hıll, New York, Volume 1 Pages 1065-1093, 2001.
Ross R. The biology of atherosclerosis. In:Topol E J, ed. Comprehensive Cardiovascular Medicine. Philadelphia:lippincott-Raven, 1998:13.
Iiyama K, Hajra L, Iiyama M, Li H.Patterns of vascular cell adhesion molecule-1 and intracellular adhesion molecule-1 expression in rabbit and Mouse atherosclerotic lesions and at site predisposed to lesion formation. Circ Res 1999; 85,:199-207.
Expert Dyslipidemia Panel of the International Atherosclerosis Society Panel members. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia— full report. J Clin Lipidol, Jan-Feb 2014;8(1), 29-60.
Lesckha S, Alkadhi H, Plass A, Desbiolles L Grunenfelder J, Merincek B, Wildermuth S. Accuracy of MSCT coronary angiography with 64-slice technology: Firs experience. Eur Heart J 2005; 1482-1487.
Erzengin F, Büyüköztürk K. Cardiac Imaging in Textbook of Internal Medicine, Ed: Kemalettin Büyüköztürk, Faruk Erzengin et all. Nobel, 2007, Istanbul, 1623-1644.
Westendorp RG, Assendelft WJ, Elzen WP, Cessie S, Gussekloo J; Use of Framingham risc and new biomarkers to predict cardiovascular mortality in older people: Population base observational cohort study. BMJ. 2009, 8; 338: a 3083.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adult (Adult Treatment Panel III) final report. Circulation, 2002; 106:3143-421.
Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menoti A, De Backer G: Estimation of ten year risk of fatal cardiovascular disease in Europe: The SCORE Project. European Heart Journal, 2003, 290: 898-904.
Hendel RC, Patel MR, Kramer CM, Poon M. ACC/ACR/SCMR/ASNC /NASCI/ SCAI/SIR Apropriateness Criteria for Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging. Journal of the American College of Cardiology, 48 (No.7); 1-23, 2006.
Achenbach S, Daniel WG: Computed Tomography of the Heart. Braunwald’s Heart Disease, 7th edition, Elsevier Saunders, Pensilvania,USA, 2005, 285-287.
Higgins CB, de Roos A: MRI and CT of the Cardiovascular system. Lipincor &Williams and Wilkins,USA and the Netherlands, 2006.
Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffmann U, MacNeill B, Pohle K, Baum U, Anders K, Jang IK, Daniel WG, Brady TJ. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravscular ultrasound. Circulation 2004; 109:14-17.
Sangiorgy G, Rumberg J A,Severson A, et al. Arterial calcificationand not lumen stenosis is highly correlated with atherosclerotic plaqueburden in humans: A histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol 1998; 31: 126-133.
Mintz GS, Pichard AD, Pompa JJ, et al. Determinants and correlates of target lesions calcium in coronary artery disease: A clinicali angiographic and intravascular ultasoun study. J Am Coll Cardiol 1997; 29: 268-274.
Yönal İ, Banzagch M, Özcan M, Adalet K, Erzengin F: Cardiac Computed Tomography; The Unique Noninvasive Method For The Detection Of Coronary Atherosclerotic Plaque Morphology And For The Diagnosis Of Silent Ischemia, Lumen Narrowing Calcification Of Adventitia: With Two Case Reports. The Heart Surgery Forum. A Cardiothoracic Multimedia Journal, Vol.12 (Supl.1), 2009, p:69-70.
Erzengin F:Adventitial Calcification: Surprise Location. Atherosclerotic and calcified plaques begin and grow up not only beneath the endothelium, but also on the adventitia. 78th European Atherosclerosis Society Congress (78th EAS Congress), June 20-23, 2010, Hamburg, Germany.
Erzengin F: Adventitial (Erzengin’s) Atherosclrero-calcification: Surprise Location. Atherosclerotic and calcified plaques begin and grow up not only beneath the endothelium, but also on the adventitia. The 3th World Medicine Congress İn abstract book, Page 4 September 20-23, 2010 / Nalchik-Russia.
Bissen E.A. Plaque Adventitia: Service Hatch or Battleground? 79th EAS Congress Gothenburg, Sweden, June 26-29, 2011.
Erzengin F: Erzengin’s Polypill: An additional and new medical treatment of atherosclerocalcifications. International Journal of Cardiology. Volume147, Page 111-112, 2012.
Efe D and Aygun F. Assessment of the Relationship Between Non-alcoholic Fatty Liver Disease and CAD using MSCT. Arq Bras Cardiol, 2014, 102 (1), 10-18.
Lee S, Chang H, Sung J, Kim K, Shin S, Cho I, Shim C, Hong G, Chung N. The Impact of Obesity on Subclinical Coronary Atherosclerosis According to the Risk of Cardiovascular Disease. Obesity, july 2014, 22 (7), 1762-1768.
LIacobellis G, Ribaudo MC, Zappaterrano A,Iannucci CV, Leonetti F: Relation between epicardial adipose tissue and left ventricular mass. Am.J Cardiol, 2004, 94,1084-7.