Noninvasive atherosclerosis imaging modalities and their application to investigating cardiovascular drug effects in rheumatoid arthritis

Victoria Furer, Zahi A. Fayad, Michael E. Farkouh, David Rosenbaum, Jeffrey D. Greenberg

Research output: Contribution to journalReview articlepeer-review

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that affects not only joints but also the cardiovascular (CV) system. Premature endothelial dysfunction and accelerated atherosclerosis are pertinent findings in patients with RA, resulting in increased CV morbidity and mortality. Thus, detection of subclinical atherosclerosis is important in RA management. A range of promising imaging modalities is currently available to visualize early vascular disease and monitor changes in atherosclerotic plaque burden, serving as important tools in CV risk stratifications and as surrogate markers for CV endpoints in intervention trials. This review summarizes various noninvasive imaging modalities, implemented in widespread clinical use, such as vascular ultrasonography and cardiac computer tomography, as well as novel emerging technologies, such as magnetic resonance imaging and positron emission tomography. These novel technologies make a step forward in the evaluation and quantification of atherosclerotic plaque features, permitting the detection of vulnerable plaque as well as functional assessment of vessel wall metabolic activity that was previously not achievable. Application of the imaging modalities to monitor CV drug effects in therapeutic clinical trials in both the general and RA population is further presented and discussed.

Original languageEnglish
Pages (from-to)739-749
Number of pages11
JournalDrug Development Research
Volume72
Issue number8
DOIs
StatePublished - Dec 2011
Externally publishedYes

Keywords

  • atherosclerosis
  • cardiovascular imaging
  • drug effects
  • magnetic resonance imaging (MRI)
  • positron emission tomography (PET)
  • rheumatoid arthritis
  • ultrasonography (US)

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