TY - JOUR
T1 - Sex differences in diagnostic modalities of atherosclerosis in the macrocirculation
AU - Kerkhof, Peter L. M.
AU - Tona, Francesco
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/11
Y1 - 2023/11
N2 - Asymptomatic atherosclerosis begins early in life and may progress in a sex-specific manner to become the major cause of cardiovascular morbidity and death. As diagnostic tools to evaluate atherosclerosis in the macrocirculation, we discuss imaging methods (in terms of computed tomography, positron emission tomography, intravascular ultrasound, magnetic resonance imaging, and optical coherence tomography), along with derived scores (Agatston, Gensini, Leaman, Syntax), and also hemodynamic indices of vascular stiffness (including flow-mediated dilation, shear stress, pulse pressure, augmentation index, arterial distensibility), assessment of plaque properties (composition, erosion, rupture), stenosis measures such as fractional flow reserve. Moreover, biomarkers including matrix metalloproteinases, vascular endothelial growth factors and miRNAs, as well as the impact of machine learning support, are described. Special attention is given to age-related aspects and sex-specific characteristics, along with clinical implications. Knowledge gaps are identified and directions for future research formulated.
AB - Asymptomatic atherosclerosis begins early in life and may progress in a sex-specific manner to become the major cause of cardiovascular morbidity and death. As diagnostic tools to evaluate atherosclerosis in the macrocirculation, we discuss imaging methods (in terms of computed tomography, positron emission tomography, intravascular ultrasound, magnetic resonance imaging, and optical coherence tomography), along with derived scores (Agatston, Gensini, Leaman, Syntax), and also hemodynamic indices of vascular stiffness (including flow-mediated dilation, shear stress, pulse pressure, augmentation index, arterial distensibility), assessment of plaque properties (composition, erosion, rupture), stenosis measures such as fractional flow reserve. Moreover, biomarkers including matrix metalloproteinases, vascular endothelial growth factors and miRNAs, as well as the impact of machine learning support, are described. Special attention is given to age-related aspects and sex-specific characteristics, along with clinical implications. Knowledge gaps are identified and directions for future research formulated.
KW - Atherosclerosis
KW - Diagnostic modalities
KW - Macrocirculation
KW - Medical imaging
KW - Sex differences
KW - Women
UR - http://www.scopus.com/inward/record.url?scp=85172022730&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.atherosclerosis.2023.117275
DO - https://doi.org/10.1016/j.atherosclerosis.2023.117275
M3 - Review article
C2 - 37783644
SN - 0021-9150
VL - 384
JO - Atherosclerosis
JF - Atherosclerosis
M1 - 117275
ER -