The role of non-invasive imaging methods in heart coronary arteries evaluation: a literature review

Martynas Bučnius1, Laurynas Miščikas1, Tomas Lapinskas2

1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania 


 Atherosclerotic cardiovascular disease is the leading cause of death in developed as well as developing countries. Strategies to prevent acute coronary events and their sequelae are among our most important public health priorities. Also, identifying patients at increased risk of acute coronary events who may benefit from intensified preventative measures is a major ongoing challenge.

Imaging techniques provide a direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of the disease.  Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques.

Recent advances in non-invasive computed tomography (CT) and cardiac magnetic resonance (CMR) methods now allow detailed imaging, potentially allowing ischemic heart disease to be tracked during a patient’s lifetime and asses the risk of cardiovascular events. In particular, CT has emerged as the noninvasive modality of choice for imaging the coronary arteries, whereas CMR offers detailed assessments of myocardial perfusion, viability, and function. The clinical utility of these techniques is increasingly being supported by robust randomized controlled trial data.

Keywords: computed tomography; cardiovascular magnetic resonance; non-invasive coronary arteries imaging; coronary artery disease; risk assessment; radiology