Pathophysiology of atherosclerotic disease; peripheral circulation; arterial mechanics; vascular ultrasound; vascular aspects of metabolic disease; vascular pharmacology
Atherosclerosis: epidemiology, prevention and clinical care
Damiano Baldassarre, PhD
Head of the Unit for the Study of Arterial Morphology and Function
(Monzino Cardiology Center IRCCS, Via C Parea, 4 - Milano. Scientific director; Prof. Elena Tremoli)
Mauro Amato, Ph.D. (email@example.com)
Beatrice Frigerio, Ph.D. (firstname.lastname@example.org)
Alessio Ravani, MSc. (email@example.com)
Daniela Sansaro, MSc. (firstname.lastname@example.org)
Daniela Coggi, MSc. (email@example.com)
The research is focused on the non-invasive assessment of early atherosclerosis in vivo in humans. Most studies are performed using B-mode ultrasound. Such technique provides information on the presence and extent of atherosclerotic plaques, arterial wall thickness (intima media thickness or IMT), vessel lumen diameter, and plaque composition and of their changes over time. These variables are used as independent risk factors of cardiovascular events and as "surrogate" markers of atherosclerosis in interventional studies. The carotid IMT, for example, is the only marker of preclinical atherosclerosis accepted by the American Heart Association, in place of hard clinical endpoints, in pharmacological studies for the approval of new drugs. The Unit is also strongly committed in developing new strategies for the better estimation of the global cardiovascular risk based on the concept of "integrated biomarkers”. The ultrasonographic measurement of acute changes induced by flow in the diameter of the brachial artery (flow-mediated vasodilatation or FMD), also provides information on endothelial function. Endothelial dysfunction is a very early index (and also predictor) of atherosclerotic disease and patients exposed to risk factors show endothelial dysfunction even in the absence of overt atherosclerotic disease.
Main research topics of the Unit are:
- the identification of new atherosclerosis risk/protective factors based on the effect that they have on arterial morphology and function.
- the development of new non-invasive tools for the study of atherosclerosis and for improving predictability of vascular events.
- the assessment of the association between changes over time of the ultrasonographic variables considered (progression/regression) and 1) conventional/emerging risk factors and 2) incidence of cardiovascular events.
- the assessment of the effects of pharmacological treatments on morphological and functional properties of superficial arteries.
In addition, the Unit coordinates and acts as core laboratory in national and international multicenter studies on the epidemiology of atherosclerosis.