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These broader exposures include adverse socioeconomic status, air and noise pollution, attributes of the built environment, and ambient temperatures, among others, which exert complex mechanistic influences that often involve neural-autonomic-immune pathways that promote traditional cardiovascular disease risk factors and atherosclerosis. Advanced noninvasive imaging modalities, including positron emission tomography, computed tomography, magnetic resonance imaging, and ultrasound, allow for assessment of subclinical vascular changes, such as arterial inflammation and plaque burden, as well as assessments of changes in other organs, including the brain and inflammatory tissues, that associate with these exposures and have the potential to clarify the mechanisms of exposure-related pathology. This review synthesizes current evidence from multimodality imaging studies linking socioeconomic status, air pollution, noise, and other environmental exposures to imaging markers of cardiovascular disease. These findings suggest opportunities to deeply characterize underlying mechanisms, refine risk assessment, prioritize targeted interventions, and inform policies aimed at mitigating adverse exposures. Through this framework, we aim to catalyze a broader approach to preventing cardiovascular disease that recognizes the profound interplay among the social, environmental, and biological determinants of health.<\/jats:p>","DOI":"10.1161\/atvbaha.125.322470","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T09:04:56Z","timestamp":1760000696000},"page":"2164-2178","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Imaging Findings Associated With Socioenvironmental Exposures Inform Mechanisms of Cardiovascular Disease"],"prefix":"10.1161","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5033-8881","authenticated-orcid":true,"given":"Shady","family":"Abohashem","sequence":"first","affiliation":[{"name":"Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston (S.A., B.F., A.T., M.T.O.)."},{"name":"Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston (S.A., F.S., A.T., M.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6990-8214","authenticated-orcid":true,"given":"Fatima","family":"Saeed","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston (S.A., F.S., A.T., M.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-4150","authenticated-orcid":true,"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology\u2014Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Germany (T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1122-7695","authenticated-orcid":true,"given":"Sadeer G.","family":"Al-Kindi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Center for Health and Nature, Houston Methodist, TX (S.G.A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2466-4827","authenticated-orcid":true,"given":"Borek","family":"Foldyna","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston (S.A., B.F., A.T., M.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-7347","authenticated-orcid":true,"given":"Zahi A.","family":"Fayad","sequence":"additional","affiliation":[{"name":"Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (Z.A.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9211-5483","authenticated-orcid":true,"given":"Ahmed","family":"Tawakol","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston (S.A., B.F., A.T., M.T.O.)."},{"name":"Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston (S.A., F.S., A.T., M.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1001-1718","authenticated-orcid":true,"given":"Michael T.","family":"Osborne","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston (S.A., B.F., A.T., M.T.O.)."},{"name":"Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston (S.A., F.S., A.T., M.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","volume-title":"World Heart Report 2023: Confronting the World\u2019s Number One Killer","year":"2023","unstructured":"World Heart Report 2023: Confronting the World\u2019s Number One Killer. 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