Education & Workforce Development

Non-invasive identification of high-risk coronary plaques remains the most significant problem in health care today, based on the morbidity and mortality rates of plaque rupture/erosion among US citizens. High-risk lesions have a known morphology including a thin fibrous cap, a lipid or necrotic core, and positive remodeling. This data is based on IVUS, an invasive and impractical surveillance tool. CT has emerged as a new tool to study the coronary arteries. The goal of this proposal is to create a Partners Radiology team to advance our understanding of CT and to study characteristics of culprit lesions such as low attenuation and spotty calcification, unique to acute coronary syndrome patients. Initial plaque CT attenuation profiles demonstrate our potential to differentiate between high and low risk, validated by detailed histopathology. We propose to extend this work with biomechanical factors such as low endothelial shear stress (ESS) that modulate endothelial gene expression and create a local milieu that favors the formation and progression of atherosclerotic plaques. This proposal will create a joint BWH-MGH team and provide resources for collaboration not otherwise available.

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