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

Abstract

AbstractRheumatoid 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. Drug Dev Res 72:739–749, 2011. © 2011 Wiley Periodicals, Inc.