Symposium 20
3月28日［日］08:45-10:15
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Vulnerable plaques and vulnerable patients: Up-to-Date
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「不安定プラーク：vulnerable plaque」は、1989年にMullerらによって提唱された比較的古い概念で、将来の血栓形成に引き続いて急性冠症候群や心臓突然死などの心血管イベントの発症リスクを有する動脈硬化巣と定義されている。その後現在までの約30年の間に冠動脈硬化症の基礎的な病態解明が進み、同時に臨床的なエビデンスが積み重なって不安定プラークに関する理解が深まってきているが、実際の診療現場における心血管イベントの一次および二次予防にもたらせた成果は未だ不十分と思われる。本シンポジウムでは、不安定プラークの病態と診断に関して、病理組織を含む不安定プラークの基礎医学的な最新の知見、ポジトロンエミッションCT（FDG-PET）、MRI、冠動脈CTなどの非侵襲的診断、血管内超音波（IVUS）、光干渉断層法（OCT）、近赤外線スペクトロスコピー（NIRS）などの侵襲的冠動脈イメージングによる診断の現状、さらにhigh sensitivity-CRPに代表される血液中のバイオマーカーなどについてこの分野のエキスパートから発表いただき、最新の知見を知る機会としたい。さらにこれらの発表から残された問題点を整理し、さらに精度の高い診断に基づいてどのような予防的・治療的介入を行っていくかに関して、本学術集会のメインテーマである「Next Stage」につながるような議論を行いたい。
The concept of “Vulnerable plaque” was proposed by Dr. Muller et al. in1989, and it is defined as atherosclerotic plaques that place patients at high risk for developing cardiovascular events such as acute coronary syndrome and sudden cardiac death following subsequent destabilization and thrombus formation. During the past 30 years, our understanding of “vulnerable plaque” became deeper due to the progress in basic researches on the mechanisms of coronary atherosclerosis as well as the accumulation of clinical findings. However, the beneficial impact of this concept on primary and secondary prevention of cardiovascular events appears to be still insufficient.
In this symposium, we will have an opportunity to get the latest knowledge from experts in this field. The symposium will cover the basic mechanisms, non-invasive diagnosis (positron emission CT: FDG-PET, MRI, coronary CT),invasive diagnostic imaging (intravascular ultrasound: IVUS, optical coherence tomography: OCT), near-infrared spectroscopy: NIRS), and blood biomarkers (such as high sensitivity-CRP) of vulnerable plaques. Based on the lectures, we will have discussion about remaining questions to be answered as well as what preventive/therapeutic interventions should be taken based on accurate diagnosis of vulnerable plaque.
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Shiro Uemura
Cardiovascular Medicine , Kawasaki Medical School, Kurashiki
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Ik-Kyung Jang
Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Ik-Kyung Jang
Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Kenichiro Otsuka
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka
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Takashi Kubo
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama
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Kensuke Nishimiya
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai
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Kazuhiro Nakao
Department of Cardiovascular Medicine, National Cerebral and Cardiovacular Center, Suita
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