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Imaging atherosclerosis in HIV: carotid intima-media thickness and beyond

  • Chris T. Longenecker
    Affiliations
    Harrington-McLaughlin Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, Ohio

    Case Western Reserve University, Cleveland, Ohio
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  • Brian D. Hoit
    Correspondence
    Reprint requests: Brian D. Hoit, MD, Division of Cardiology, University Hospitals Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106
    Affiliations
    Harrington-McLaughlin Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, Ohio

    Case Western Reserve University, Cleveland, Ohio
    Search for articles by this author
Published:November 15, 2011DOI:https://doi.org/10.1016/j.trsl.2011.10.007
      Chronic immune activation and inflammation are associated with an increased risk of atherosclerosis in HIV-infected patients. In this review, we discuss the role of established and novel imaging modalities to define more accurately the structure and function of inflammation-mediated atherosclerosis in the context of HIV. Historically, carotid ultrasound studies were the first to show higher rates of subclinical atherosclerosis in HIV-infected subjects versus uninfected controls. However, computed tomography is the noninvasive gold standard for imaging the coronary arteries, and studies in HIV suggest a higher prevalence of noncalcified plaque. Endothelial dysfunction can be quantified by measuring flow-mediated brachial artery dilation by ultrasound and has been used extensively in antiretroviral switching trials and small pilot trials of therapeutics to assess cardiovascular risk in this population. In the future, novel imaging modalities such as intracoronary optical coherence tomography, positron emission tomography imaging of 18F-fluorodeoxyglucose uptake, and molecular-targeted magnetic resonance imaging will characterize the burden of vulnerable plaque and other unique features of inflammatory atherosclerosis in HIV.

      Abbreviations:

      2-D (2-dimensional), 3-D (3-dimensional), ART (antiretroviral therapy), CIMT (carotid intima-media thickness), CT (computed tomography), CTA (computed tomography angiography), FDG (18F-fluorodeoxyglucose), FMD (flow mediated brachial artery dilation), IVUS (intravascular ultrasound), MACS (Multi-center AIDS Cohort Study), MRA (magnetic resonance imaging angiography), MRI (magnetic resonance imaging), OCT (optical coherence tomography), PET (positron emission tomography), PI (protease inhibitor), SPECT (single photon emission computed tomography), TCFA (thin-capped fibroatheroma), USPIO (ultrasmallsuperparamagnetic iron oxide), WIHS (Women's Interagency HIV Study)
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      References

        • Libby P.
        • Ridker P.M.
        • Hansson G.K.
        Inflammation in atherosclerosis: from pathophysiology to practice.
        J Am Coll Cardiol. 2009; 54: 2129-2138
        • Ridker P.M.
        • Danielson E.
        • Fonseca F.A.
        • et al.
        Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein.
        N Engl J Med. 2008; 359: 2195-2207
        • Henry K.
        • Melroe H.
        • Huebsch J.
        • et al.
        Severe premature coronary artery disease with protease inhibitors.
        Lancet. 1998; 351: 1328
        • Bots M.L.
        • Hoes A.W.
        • Koudstaal P.J.
        • Hofman A.
        • Grobbee D.E.
        Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study.
        Circulation. 1997; 96: 1432-1437
        • Chambless L.E.
        • Heiss G.
        • Folsom A.R.
        • et al.
        Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993.
        Am J Epidemiol. 1997; 146: 483-494
        • O'Leary D.H.
        • Polak J.F.
        • Kronmal R.A.
        • et al.
        Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group.
        N Engl J Med. 1999; 340: 14-22
        • Pignoli P.
        • Tremoli E.
        • Poli A.
        • Oreste P.
        • Paoletti R.
        Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.
        Circulation. 1986; 74: 1399-1406
        • Stein J.H.
        • Korcarz C.E.
        • Hurst R.T.
        • et al.
        Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine.
        J Am Soc Echocardiogr. 2008; 21: 93-111
        • Makris G.C.
        • Lavida A.
        • Griffin M.
        • Geroulakos G.
        • Nicolaides A.N.
        Three-dimensional ultrasound imaging for the evaluation of carotid atherosclerosis.
        Atherosclerosis. 2011 May 13; ([Epub ahead of print])
        • Hulten E.
        • Mitchell J.
        • Scally J.
        • Gibbs B.
        • Villines T.C.
        HIV positivity, protease inhibitor exposure and subclinical atherosclerosis: a systematic review and meta-analysis of observational studies.
        Heart. 2009; 95: 1826-1835
        • Hsue P.Y.
        • Lo J.C.
        • Franklin A.
        • et al.
        Progression of atherosclerosis as assessed by carotid intima-media thickness in patients with HIV infection.
        Circulation. 2004; 109: 1603-1608
        • Currier J.S.
        • Kendall M.A.
        • Henry W.K.
        • et al.
        Progression of carotid artery intima-media thickening in HIV-infected and uninfected adults.
        AIDS. 2007; 21: 1137-1145
        • Mercie P.
        • Thiebaut R.
        • Aurillac-Lavignolle V.
        • et al.
        Carotid intima-media thickness is slightly increased over time in HIV-1-infected patients.
        HIV Med. 2005; 6: 380-387
        • Hsue P.Y.
        • Hunt P.W.
        • Sinclair E.
        • et al.
        Increased carotid intima-media thickness in HIV patients is associated with increased cytomegalovirus-specific T-cell responses.
        AIDS. 2006; 20: 2275-2283
        • Kaplan R.C.
        • Sinclair E.
        • Landay A.L.
        • et al.
        T cell activation and senescence predict subclinical carotid artery disease in HIV-infected women.
        J Infect Dis. 2011; 203: 452-463
        • El-Sadr W.M.
        • Lundgren J.D.
        • Neaton J.D.
        • et al.
        CD4+ count-guided interruption of antiretroviral treatment.
        N Engl J Med. 2006; 355: 2283-2296
        • Friis-Moller N.
        • Reiss P.
        • Sabin C.A.
        • et al.
        Class of antiretroviral drugs and the risk of myocardial infarction.
        N Engl J Med. 2007; 356: 1723-1735
        • Jang J.J.
        • Berkheimer S.B.
        • Merchant M.
        • Krishnaswami A.
        Asymmetric dimethylarginine and coronary artery calcium scores are increased in patients infected with human immunodeficiency virus.
        Atherosclerosis. 2011; 217: 514-517
        • Lo J.
        • Abbara S.
        • Shturman L.
        • et al.
        Increased prevalence of subclinical coronary atherosclerosis detected by coronary computed tomography angiography in HIV-infected men.
        AIDS. 2010; 24: 243-253
        • Guaraldi G.
        • Scaglioni R.
        • Zona S.
        • et al.
        Epicardial adipose tissue is an independent marker of cardiovascular risk in HIV-infected patients.
        AIDS. 2011; 25: 1199-1205
        • Falcone E.L.
        • Mangili A.
        • Skinner S.
        • et al.
        Framingham risk score and early markers of atherosclerosis in a cohort of adults infected with HIV.
        Antivir Ther. 2011; 16: 1-8
        • Fitch K.V.
        • Lo J.
        • Abbara S.
        • et al.
        Increased coronary artery calcium score and noncalcified plaque among HIV-infected men: relationship to metabolic syndrome and cardiac risk parameters.
        J Acquir Immune Defic Syndr. 2010; 55: 495-499
        • Crum-Cianflone N.
        • Krause D.
        • Wessman D.
        • et al.
        Fatty liver disease is associated with underlying cardiovascular disease in HIV-infected persons(∗).
        HIV Med. 2011; 12: 463-471
        • Burdo T.H.
        • Lo J.
        • Abbara S.
        • et al.
        Soluble CD163, a novel marker of activated macrophages, is elevated and associated with noncalcified coronary plaque in HIV-infected patients.
        J Infect Dis. 2011; 204: 1227-1236
        • Bischoff B.
        • Hein F.
        • Meyer T.
        • et al.
        Comparison of sequential and helical scanning for radiation dose and image quality: results of the prospective multicenter study on radiation dose estimates of cardiac CT angiography (PROTECTION) I Study.
        AJR Am J Roentgenol. 2010; 194: 1495-1499
        • Achenbach S.
        • Marwan M.
        • Ropers D.
        • et al.
        Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition.
        Eur Heart J. 2010; 31: 340-346
        • Sakuma H.
        Coronary CT versus MR angiography: the role of MR angiography.
        Radiology. 2011; 258: 340-349
        • Kramer H.
        • Nikolaou K.
        • Sommer W.
        • Reiser M.F.
        • Herrmann K.A.
        Peripheral MR angiography.
        Magn Reson Imaging Clin N Am. 2009; 17: 91-100
        • Mostardi P.M.
        • Haider C.R.
        • Glockner J.F.
        • Young P.M.
        • Riederer S.J.
        High spatial and temporal resolution imaging of the arterial vasculature of the lower extremity with contrast enhanced MR angiography.
        Clin Anat. 2011; 24: 478-488
        • Blackham K.A.
        • Passalacqua M.A.
        • Sandhu G.S.
        • et al.
        Applications of time-resolved MR angiography.
        AJR Am J Roentgenol. 2011; 196: W613-W620
        • Floris-Moore M.
        • Fayad Z.A.
        • Berman J.W.
        • et al.
        Association of HIV viral load with monocyte chemoattractant protein-1 and atherosclerosis burden measured by magnetic resonance imaging.
        AIDS. 2009; 23: 941-949
        • Yonemura A.
        • Momiyama Y.
        • Fayad Z.A.
        • et al.
        Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques detected by noninvasive magnetic resonance imaging.
        J Am Coll Cardiol. 2005; 45: 733-742
        • Corti R.
        • Fuster V.
        • Fayad Z.A.
        • et al.
        Effects of aggressive versus conventional lipid-lowering therapy by simvastatin on human atherosclerotic lesions: a prospective, randomized, double-blind trial with high-resolution magnetic resonance imaging.
        J Am Coll Cardiol. 2005; 46: 106-112
        • Ding J.
        • Hsu F.C.
        • Harris T.B.
        • et al.
        The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA).
        Am J Clin Nutr. 2009; 90: 499-504
        • Iacobellis G.
        • Pellicelli A.M.
        • Sharma A.M.
        • et al.
        Relation of subepicardial adipose tissue to carotid intima-media thickness in patients with human immunodeficiency virus.
        Am J Cardiol. 2007; 99: 1470-1472
        • Iacobellis G.
        • Sharma A.M.
        • Pellicelli A.M.
        • et al.
        Epicardial adipose tissue is related to carotid intima-media thickness and visceral adiposity in HIV-infected patients with highly active antiretroviral therapy-associated metabolic syndrome.
        Curr HIV Res. 2007; 5: 275-279
        • Lo J.
        • Abbara S.
        • Rocha-Filho J.A.
        • et al.
        Increased epicardial adipose tissue volume in HIV-infected men and relationships to body composition and metabolic parameters.
        AIDS. 2010; 24: 2127-2130
        • Faulx M.D.
        • Wright A.T.
        • Hoit B.D.
        Detection of endothelial dysfunction with brachial artery ultrasound scanning.
        Am Heart J. 2003; 145: 943-951
        • Fathi R.
        • Haluska B.
        • Isbel N.
        • Short L.
        • Marwick T.H.
        The relative importance of vascular structure and function in predicting cardiovascular events.
        J Am Coll Cardiol. 2004; 43: 616-623
        • Yeboah J.
        • Folsom A.R.
        • Burke G.L.
        • et al.
        Predictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: the multi-ethnic study of atherosclerosis.
        Circulation. 2009; 120: 502-509
        • Corretti M.C.
        • Anderson T.J.
        • Benjamin E.J.
        • et al.
        Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force.
        J Am Coll Cardiol. 2002; 39: 257-265
        • Solages A.
        • Vita J.A.
        • Thornton D.J.
        • et al.
        Endothelial function in HIV-infected persons.
        Clin Infect Dis. 2006; 42: 1325-1332
        • Blum A.
        • Hadas V.
        • Burke M.
        • Yust I.
        • Kessler A.
        Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction.
        Clin Cardiol. 2005; 28: 149-153
        • Torriani F.J.
        • Komarow L.
        • Parker R.A.
        • et al.
        Endothelial function in human immunodeficiency virus-infected antiretroviral-naive subjects before and after starting potent antiretroviral therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s.
        J Am Coll Cardiol. 2008; 52: 569-576
        • Vernon L.T.
        • Babineau D.C.
        • Demko C.A.
        • et al.
        A prospective cohort study of periodontal disease measures and cardiovascular disease markers in HIV-infected adults.
        AIDS Res Hum Retroviruses. 2011 May 9; ([Epub ahead of print])
      1. Longenecker C, Hileman C, Carman T, et al. Vitamin D supplementation and endothelial function among vitamin D-deficient HIV-infected persons: a randomized placebo-controlled trial. 18th Conference on Retroviruses and Opportunistic Infections, Boston, MA, 2011.

        • Stein J.H.
        • Klein M.A.
        • Bellehumeur J.L.
        • et al.
        Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction.
        Circulation. 2001; 104: 257-262
        • Murphy R.L.
        • Berzins B.
        • Zala C.
        • et al.
        Change to atazanavir/ritonavir treatment improves lipids but not endothelial function in patients on stable antiretroviral therapy.
        AIDS. 2010; 24: 885-890
        • Flammer A.J.
        • Vo N.T.
        • Ledergerber B.
        • et al.
        Effect of atazanavir versus other protease inhibitor-containing antiretroviral therapy on endothelial function in HIV-infected persons: randomised controlled trial.
        Heart. 2009; 95: 385-390
        • Hurlimann D.
        • Chenevard R.
        • Ruschitzka F.
        • et al.
        Effects of statins on endothelial function and lipid profile in HIV infected persons receiving protease inhibitor-containing anti-retroviral combination therapy: a randomised double blind crossover trial.
        Heart. 2006; 92: 110-112
        • Chow D.C.
        • Stein J.H.
        • Seto T.B.
        • et al.
        Short-term effects of extended-release niacin on endothelial function in HIV-infected patients on stable antiretroviral therapy.
        AIDS. 2010; 24: 1019-1023
        • Gupta S.K.
        • Johnson R.M.
        • Mather K.J.
        • et al.
        Anti-inflammatory treatment with pentoxifylline improves HIV-related endothelial dysfunction: a pilot study.
        AIDS. 2010; 24: 1377-1380
        • Gupta S.K.
        • Johnson R.M.
        • Saha C.
        • et al.
        Improvement in HIV-related endothelial dysfunction using the anti-inflammatory agent salsalate: a pilot study.
        AIDS. 2008; 22: 653-655
        • Hileman C.O.
        • Carman T.L.
        • Gripshover B.M.
        • et al.
        Salsalate is poorly tolerated and fails to improve endothelial function in virologically suppressed HIV-infected adults.
        AIDS. 2010; 24: 1958-1961
        • Hendel R.C.
        • Berman D.S.
        • Di Carli M.F.
        • et al.
        ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the american college of cardiology foundation appropriate use criteria task force, the american society of nuclear cardiology, the american college of radiology, the american heart association, the american society of echocardiography, the society of cardiovascular computed tomography, the society for cardiovascular magnetic resonance, and the society of nuclear medicine.
        J Am Coll Cardiol. 2009; 53: 2201-2229
        • Catzin-Kuhlmann A.
        • Orea-Tejeda A.
        • Castillo-Martinez L.
        • et al.
        Human immunodeficiency virus-infected subjects have no altered myocardial perfusion.
        Int J Cardiol. 2007; 122: 90-92
        • Lebech A.M.
        • Kristoffersen U.S.
        • Wiinberg N.
        • et al.
        Coronary and peripheral endothelial function in HIV patients studied with positron emission tomography and flow-mediated dilation: relation to hypercholesterolemia.
        Eur J Nucl Med Mol Imaging. 2008; 35: 2049-2058
        • Kristoffersen U.S.
        • Wiinberg N.
        • Petersen C.L.
        • et al.
        Reduction in coronary and peripheral vasomotor function in patients with HIV after initiation of antiretroviral therapy: a longitudinal study with positron emission tomography and flow-mediated dilation.
        Nucl Med Commun. 2010; 31: 874-880
        • Vaccarino V.
        • Khan D.
        • Votaw J.
        • et al.
        Inflammation is related to coronary flow reserve detected by positron emission tomography in asymptomatic male twins.
        J Am Coll Cardiol. 2011; 57: 1271-1279
        • Ishimori M.L.
        • Martin R.
        • Berman D.S.
        • et al.
        Myocardial ischemia in the absence of obstructive coronary artery disease in systemic lupus erythematosus.
        JACC Cardiovasc Imaging. 2011; 4: 27-33
        • Weber T.
        • Auer J.
        • O'Rourke M.F.
        • et al.
        Arterial stiffness, wave reflections, and the risk of coronary artery disease.
        Circulation. 2004; 109: 184-189
        • Laurent S.
        • Boutouyrie P.
        • Asmar R.
        • et al.
        Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients.
        Hypertension. 2001; 37: 1236-1241
        • van Vonderen M.G.
        • Smulders Y.M.
        • Stehouwer C.D.
        • et al.
        Carotid intima-media thickness and arterial stiffness in HIV-infected patients: the role of HIV, antiretroviral therapy, and lipodystrophy.
        J Acquir Immune Defic Syndr. 2009; 50: 153-161
        • Seaberg E.C.
        • Benning L.
        • Sharrett A.R.
        • et al.
        Association between human immunodeficiency virus infection and stiffness of the common carotid artery.
        Stroke. 2010; 41: 2163-2170
        • Schillaci G.
        • De Socio G.V.
        • Pirro M.
        • et al.
        Impact of treatment with protease inhibitors on aortic stiffness in adult patients with human immunodeficiency virus infection.
        Arterioscler Thromb Vasc Biol. 2005; 25: 2381-2385
        • Baker J.V.
        • Duprez D.
        • Rapkin J.
        • et al.
        Untreated HIV infection and large and small artery elasticity.
        J Acquir Immune Defic Syndr. 2009; 52: 25-31
        • Schillaci G.
        • De Socio G.V.
        • Pucci G.
        • et al.
        Aortic stiffness in untreated adult patients with human immunodeficiency virus infection.
        Hypertension. 2008; 52: 308-313
        • Lazar J.M.
        • Wu X.
        • Shi Q.
        • et al.
        Arterial wave reflection in HIV-infected and HIV-uninfected Rwandan women.
        AIDS Res Hum Retroviruses. 2009; 25: 877-882
        • Ho J.E.
        • Deeks S.G.
        • Hecht F.M.
        • et al.
        Initiation of antiretroviral therapy at higher nadir CD4+ T-cell counts is associated with reduced arterial stiffness in HIV-infected individuals.
        AIDS. 2010; 24: 1897-1905
        • Boccara F.
        • Simon T.
        • Lacombe K.
        • et al.
        Influence of pravastatin on carotid artery structure and function in dyslipidemic HIV-infected patients receiving antiretroviral therapy.
        AIDS. 2006; 20: 2395-2398
        • Kaplan R.C.
        • Sinclair E.
        • Landay A.L.
        • et al.
        T cell activation predicts carotid artery stiffness among HIV-infected women.
        Atherosclerosis. 2011; 217: 207-213
        • van Vonderen M.G.
        • Hassink E.A.
        • van Agtmael M.A.
        • et al.
        Increase in carotid artery intima-media thickness and arterial stiffness but improvement in several markers of endothelial function after initiation of antiretroviral therapy.
        J Infect Dis. 2009; 199: 1186-1194
        • Sevastianova K.
        • Sutinen J.
        • Westerbacka J.
        • Ristola M.
        • Yki-Jarvinen H.
        Arterial stiffness in HIV-infected patients receiving highly active antiretroviral therapy.
        Antivir Ther. 2005; 10: 925-935
        • Tabib A.
        • Leroux C.
        • Mornex J.F.
        • Loire R.
        Accelerated coronary atherosclerosis and arteriosclerosis in young human-immunodeficiency-virus-positive patients.
        Coron Artery Dis. 2000; 11: 41-46
        • Hsue P.Y.
        • Giri K.
        • Erickson S.
        • et al.
        Clinical features of acute coronary syndromes in patients with human immunodeficiency virus infection.
        Circulation. 2004; 109: 316-319
        • Mintz G.S.
        • Nissen S.E.
        • Anderson W.D.
        • et al.
        American College of Cardiology clinical expert consensus document on standards for acquisition, measurement and reporting of intravascular ultrasound studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents.
        J Am Coll Cardiol. 2001; 37: 1478-1492
        • Stone G.W.
        • Maehara A.
        • Lansky A.J.
        • et al.
        A prospective natural-history study of coronary atherosclerosis.
        N Engl J Med. 2011; 364: 226-235
        • Bezerra H.G.
        • Costa M.A.
        • Guagliumi G.
        • Rollins A.M.
        • Simon D.I.
        Intracoronary optical coherence tomography: a comprehensive review clinical and research applications.
        JACC Cardiovasc Interv. 2009; 2: 1035-1046
        • Kubo T.
        • Imanishi T.
        • Takarada S.
        • et al.
        Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy.
        J Am Coll Cardiol. 2007; 50: 933-939
        • Raffel O.C.
        • Tearney G.J.
        • Gauthier D.D.
        • et al.
        Relationship between a systemic inflammatory marker, plaque inflammation, and plaque characteristics determined by intravascular optical coherence tomography.
        Arterioscler Thromb Vasc Biol. 2007; 27: 1820-1827
        • Nadkarni S.K.
        • Pierce M.C.
        • Park B.H.
        • et al.
        Measurement of collagen and smooth muscle cell content in atherosclerotic plaques using polarization-sensitive optical coherence tomography.
        J Am Coll Cardiol. 2007; 49: 1474-1481
        • Lee S.C.
        • Carr C.L.
        • Davidson B.P.
        • et al.
        Temporal characterization of the functional density of the vasa vasorum by contrast-enhanced ultrasonography maximum intensity projection imaging.
        JACC Cardiovasc Imaging. 2010; 3: 1265-1272
        • Madjid M.
        • Willerson J.T.
        • Casscells S.W.
        Intracoronary thermography for detection of high-risk vulnerable plaques.
        J Am Coll Cardiol. 2006; 47: C80-C85
        • Caplan J.D.
        • Waxman S.
        • Nesto R.W.
        • Muller J.E.
        Near-infrared spectroscopy for the detection of vulnerable coronary artery plaques.
        J Am Coll Cardiol. 2006; 47: C92-C96
        • Waxman S.
        • Dixon S.R.
        • L'Allier P.
        • et al.
        In vivo validation of a catheter-based near-infrared spectroscopy system for detection of lipid core coronary plaques: initial results of the SPECTACL study.
        JACC Cardiovasc Imaging. 2009; 2: 858-868
        • Larose E.
        • Yeghiazarians Y.
        • Libby P.
        • et al.
        Characterization of human atherosclerotic plaques by intravascular magnetic resonance imaging.
        Circulation. 2005; 112: 2324-2331
        • Larose E.
        • Kinlay S.
        • Selwyn A.P.
        • et al.
        Improved characterization of atherosclerotic plaques by gadolinium contrast during intravascular magnetic resonance imaging of human arteries.
        Atherosclerosis. 2008; 196: 919-925
        • Schaar J.A.
        • van der Steen A.F.
        • Mastik F.
        • Baldewsing R.A.
        • Serruys P.W.
        Intravascular palpography for vulnerable plaque assessment.
        J Am Coll Cardiol. 2006; 47: C86-C91
        • Fukumoto Y.
        • Hiro T.
        • Fujii T.
        • et al.
        Localized elevation of shear stress is related to coronary plaque rupture: a 3-dimensional intravascular ultrasound study with in-vivo color mapping of shear stress distribution.
        J Am Coll Cardiol. 2008; 51: 645-650
        • Sonne C.
        • Stempfle H.U.
        • Klauss V.
        • Schiele T.M.
        Intravascular ultrasound-guided percutaneous coronary intervention in a human immunodeficiency virus-positive patient with cocaine-associated acute myocardial infarction: case report and review.
        Heart Lung Circ. 2005; 14: 197-200
        • Rudd J.H.
        • Warburton E.A.
        • Fryer T.D.
        • et al.
        Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography.
        Circulation. 2002; 105: 2708-2711
        • Rudd J.H.
        • Myers K.S.
        • Bansilal S.
        • et al.
        (18)Fluorodeoxyglucose positron emission tomography imaging of atherosclerotic plaque inflammation is highly reproducible: implications for atherosclerosis therapy trials.
        J Am Coll Cardiol. 2007; 50: 892-896
        • Fifer K.M.
        • Qadir S.
        • Subramanian S.
        • et al.
        Positron emission tomography measurement of periodontal (18)f-fluorodeoxyglucose uptake is associated with histologically determined carotid plaque inflammation.
        J Am Coll Cardiol. 2011; 57: 971-976
        • Tahara N.
        • Kai H.
        • Yamagishi S.
        • et al.
        Vascular inflammation evaluated by [18F]-fluorodeoxyglucose positron emission tomography is associated with the metabolic syndrome.
        J Am Coll Cardiol. 2007; 49: 1533-1539
        • Tahara N.
        • Kai H.
        • Ishibashi M.
        • et al.
        Simvastatin attenuates plaque inflammation: evaluation by fluorodeoxyglucose positron emission tomography.
        J Am Coll Cardiol. 2006; 48: 1825-1831
      2. Burdo T, Lo J, Wei J, et al. sCD163, a novel marker of activated macrophages, is associated with noncalcified coronary plaque in HIV patients. 18th Conference on Retroviruses and Opportunistic Infections, Boston, MA, 2011.

        • Korosoglou G.
        • Weiss R.G.
        • Kedziorek D.A.
        • et al.
        Noninvasive detection of macrophage-rich atherosclerotic plaque in hyperlipidemic rabbits using “positive contrast” magnetic resonance imaging.
        J Am Coll Cardiol. 2008; 52: 483-491
        • Tang T.Y.
        • Howarth S.P.
        • Miller S.R.
        • et al.
        The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) study. Evaluation using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging in carotid disease.
        J Am Coll Cardiol. 2009; 53: 2039-2050
        • Burtea C.
        • Laurent S.
        • Murariu O.
        • et al.
        Molecular imaging of alpha v beta3 integrin expression in atherosclerotic plaques with a mimetic of RGD peptide grafted to Gd-DTPA.
        Cardiovasc Res. 2008; 78: 148-157