The fil rouge of atherosclerosis: from brain to heart imaging

Atherosclerotic disease is the underlying process behind the two leading causes of
death worldwide: ischemic stroke and myocardial infarction. Its prevalence is
remarkably high in Western populations, affecting up to 75% of men and 62% of
women aged 65 and older. Despite advances in therapy, current screening and
diagnostic strategies remain insufficient to identify high-risk individuals before an
event occurs. However, over the past decade, increasing recognition of the concept of the “vulnerable plaque” has opened new and promising perspectives in
cardiovascular medicine.
It is now widely accepted that rupture of atherosclerotic plaques—particularly in the
coronary and carotid arteries—plays a fundamental role in triggering acute events
such as myocardial infarction and ischemic stroke. Recent progress in imaging
technologies has significantly enhanced our ability to investigate plaque morphology
and composition, providing compelling evidence that specific imaging features are
associated with a higher risk of rupture, thrombosis, or embolization.
At the same time, the advent of lipid-lowering and anti-inflammatory therapies has
introduced a new dimension to the management of atherosclerosis, raising important questions about how best to integrate medical therapy and revascularization strategies. Although coronary and carotid atherosclerosis share a common pathological basis, they differ in several key aspects—biological behavior, clinical presentation, therapeutic response—which call for a more nuanced, disease-specific approach.
This conference aims to address these complexities through a multi-specialty
dialogue that brings together leading experts from Europe, Asia and the United
States. Cardiologists, neurologists, vascular surgeons, radiologists, and imaging
scientists will engage in an open exchange to explore both the shared principles and the distinctive features of atherosclerosis in the heart and brain.
Our primary goal is to highlight recent innovations in the early imaging of
atherosclerotic disease and to understand how such imaging can guide more
tailored, effective prevention strategies—ultimately aiming to reduce the burden of
myocardial infarction and ischemic stroke through individualized care.