Over a Hump for Imaging Atherosclerosis

The “Holy Grail” in molecular imaging of cardiovascular disease is sensitive, specific, economic, and radiation-free detection of atheromata prone to produce thrombotic complications.1,2 In this issue of Circulation Research , Broisat et al3 describe another step on the path toward noninvasive molecular imaging of inflammation in atherosclerotic plaque. Although still unproven, the early detection of trouble looming ahead could trigger steps for intervention, possibly involving the aggressive modulation of risk factors. Imaging might even help to define individual risk and to guide appropriate local therapy.4Article, see p 927The field has provided proof-of-concept studies for a variety of molecular targets. While searching for suitable approaches, imaging scientists have perused the work of molecular biologists and immunologists working in atherosclerosis. The recognition that inflammation drives the development and complication of atherosclerosis offers several potential imaging targets. Adhesion molecules, innate immune cells (monocytes/macrophages), extracellular matrix, oxidized lipids, and proteases all have received scrutiny,4 but vascular cell adhesion molecule-1 (VCAM-1)5 has gained considerable attention in this regard. …