Non-invasive imaging of atherosclerosis in the young

Abstract

Prevention of cardiovascular disease (CVD) remains a top priority for public healthcare and healthcare professionals worldwide. In order to achieve this more knowledge on the major cause of CVD, atherosclerosis, is warranted. This thesis studied the pathophysiology of atherosclerosis in young individuals by further unraveling factors that are related to the atherosclerotic process in early life and examined the value of non-invasive imaging markers for atherosclerosis evaluation in the young. This information may be of help to improve identification of young individuals who are at high risk for developing symptomatic CVD later in life. As such, this thesis examined the relation of circulating inflammatory biomarkers and cardiovascular (CV) risk factors with various B-mode ultrasound and Magnetic Resonance Imaging (MRI)-derived imaging markers for atherosclerosis in healthy, young children, adolescents and young adults. This thesis concluded that, in addition to ultrasound-derived parameters of the structure of the arterial wall, ultrasound-derived composition of the arterial wall as well as MRI-derived aortic wall area, thickness and pulse wave velocity are valuable tools for mapping of atherosclerosis in young individuals. Especially MRI is a promising modality that will probably rise to become one of the most important tools to detect, evaluate and monitor atherosclerosis in young individuals. As such, MRI might play a role in therapeutic and preventive strategies in young individuals who are at high-risk for developing cardiovascular disease. In addition, this thesis demonstrated that various inflammatory cells appear to be involved in the development and progression of atherosclerosis in young individuals. As such, these cells might be of use to identify, treat and monitor young individuals who are at high-risk for developing clinically manifest CVD. Future research on this matter will hopefully result in an increase in CVD prevention by early identification and treatment of individuals who are at high-risk for developing clinically manifest CVD and as such, reduce the enormous impact that CVD currently has on our global healthcare, economy and society.