Charcot and Cholesterin.

We offer here an observation written in 1866 by Jean-Martin Charcot, accompanied by drawings made during the autopsy of a patient who died of "cerebral softening." Focusing mainly on French medical progress at the time, our survey of the state of knowledge of cerebrovascular pathology indicates that Charcot completely explained the pathophysiology of cerebral infarction, describing the ulceration of an atheromatous plaque at the intima of an artery, on which a clot aggregates, blocks the vessel, or releases embolus downstream, causing cerebral ischemia and parenchymal lesions. Using the term "cholestérine" (cholesterin), the name of cholesterol at the time, he identified the biological nature of atheromatous plaques, and made detailed drawings. This observation, included in the famous thesis of Ivan Poumeau, indicates that Charcot did not neglect cerebrovascular pathology, ischemic in this case, but also pathology caused by hemorrhaging, as in the thesis of Charles Bouchard. This interest, which we see clearly during his first decade at Hôpital de la Salpêtrière, gradually turned toward other neurological pathologies that ensured his fame as a founder of neurology more enduringly and overshadowed the conceptual advances he made in the vascular domain.

High prevalence of cholesterol-rich atherosclerotic lesions in ancient mummies: A near-infrared spectroscopy study.

Computed tomography has been used previously in mummies to detect arterial calcification, which is a marker of later-stage atherosclerosis. Here, using the novel approach of near-infrared spectroscopy, we detected cholesterol-rich atherosclerotic plaques in arterial samples from ancient mummies. In this proof-of-concept study, we are the first to noninvasively detect these earlier-stage lesions in mummies from different geographical areas, suggesting that atherosclerosis has been present in humans since ancient times.

The Goal of Achieving Atherosclerotic Plaque Regression with Lipid-Lowering Therapy: Insights from IVUS Trials.

Enormous effort has been put into the prevention of atherosclerosis through risk modification, especially with lipid-lowering therapies. Regression, that is, the reversal of the atherosclerosis process, has long been a goal of atherosclerosis research among basic and clinical investigators. Intravascular ultrasound (IVUS) was developed in the 1990s as an intracoronary imaging technique to observe the details of the vessel walls and to measure the vessel lumen and plaque area with high reproducibility. Compared with the coronary angiogram, IVUS provides far more detailed information on the vessel wall. In this article, we review lipid-lowering trials that have used IVUS and discuss the current understanding of the effectiveness of aggressive lipid-lowering therapy, which inhibits atherosclerotic progression and induces regression and plaque stabilization.

Gustav Born: pioneer in imaging platelet and leukocyte biology.

Gustav Born achieved scientific fame for his application of light transmission aggregometry to the study of platelet function, but also led interdisciplinary research teams in pioneering quantitative in vivo imaging studies of platelet aggregation and leukocyte adhesion, and in conducting the first research into the biomechanical factors underlying atherosclerotic plaque rupture. Gus Born also communicated both current research findings and an integrated understanding of cardiovascular biology to a wide audience through acting as scientific advisor on several television productions. Using footage from two of these films, we discuss Gustav Born's scientific achievements and legacy.

A classic collaboration: Michael Davies on plaque vulnerability.

The British Heart Foundation sponsors the Michael Davies Young Investigator Award, and at its presentation in the Spring of 2009 two collaborators of Michael Davies spoke regarding their experiences on the Plaque Vulnerability project with him. This was to provide the winner and other nominees for the award, and colleagues at the meeting, descriptions of collaborating with Michael to sustain more than his name in association with the award. This article is an expansion of the personal reminiscences given at the time as a tribute to him, and to provide an inside story of how collaboration with such a prominent cardiac pathologist worked.

Tumor-like coronary atheroma: a modern coronary evaluation with a historical perspective.

The concept that atherosclerotic disease could be a form of neoplasm has been proposed in the medical literature for centuries, yet few modern cardiologists or pathologists describe atherosclerotic plaques as having the appearance of tumors. Although atherosclerosis is now considered to be an inflammatory disease, parallels between the pathophysiologic courses of atherosclerosis and neoplasia have been described since the 19th century. Current research is increasingly focused on mechanisms common to both diseases.Herein, we present the case of a 70-year-old man with a tumor-like coronary atheroma that was diagnosed on computed tomographic coronary angiography and confirmed with the use of intravascular ultrasound. However, the large plaque was not apparent on conventional invasive angiography. This case serves as a reminder of the limitations of invasive angiography and of the superiority of both computed tomographic coronary angiography and intravascular ultrasound in identifying and quantifying coronary plaque. We discuss our interpretation of the patient's lesion and review various theories of atherogenesis.