Regression of Atherosclerosis: Where are We Now, and Where are We Going?

Atherosclerosis is a chronic inflammatory disorder, and lipoproteins are believed to play a critical role in its initiation and progression. Increased levels of atherogenic lipoproteins (low-density lipoprotein [LDL], intermediate-density lipoprotein [IDL], very-low-density lipoprotein [VLDL] remnants, lipoprotein(a) [Lp(a)]), which all contain apolipoprotein (apo) B, are associated with increased development and progression of atherosclerosis. In contrast, high levels of high-density lipoprotein (HDL) are associated with less atherosclerosis, and HDL is thought to play a critical role in reverse cholesterol transport. Therapies that alter lipoprotein metabolism can affect the progression, stabilization, and regression of atherosclerosis, and these effects can be studied by a number of imaging modalities.