ABSTRACT
Introduction Many imaging modalities are now available to monitor the progress of structural vascular abnormalities, most commonly, atherosclerotic plaques. Refinement of these techniques and innovation in the field are progressing fast, although their applications in clinical practice are still debatable in many aspects. The use of imaging methods to quantify the progression and regression of atherosclerosis represents an evolution in our thinking about drug development. Many years ago, high blood pressure (BP), cholesterol, glucose were considered as ‘surrogate markers’ of cardiovascular disease (CVD), now they are classic risk factors, whereas newer markers/ predictors of disease such as carotid intima-media thickness (IMT), endothelial dysfunction, arterial stiffness, pulse pressure and microalbuminuria are considered as ‘surrogates’, and plasma indices, such as C-reactive protein, homocysteine, fibrinogen, etc. are considered as ‘predictors’ of future cardiovascular events. It seems that left ventricular hypertrophy (LVH), previously considered as a ‘surrogate’, has been regarded as a significant risk factor in the Framingham risk equation, WHO/ISH guideline and other risk scoring algorithms.
