scholarly journals Assessment of stunned and viable myocardium using manganese-enhanced MRI

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001646
Author(s):  
Nick B Spath ◽  
Trisha Singh ◽  
Giorgos Papanastasiou ◽  
Andrew Baker ◽  
Rob J Janiczek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intracellular Calcium ◽  
Myocardial Viability ◽  
Viable Myocardium ◽  
Calcium Handling ◽  
Infarcted Myocardium ◽  
Enhanced Mri ◽  
Manganese Uptake ◽  
Healthy Control ◽  
Manganese Enhanced Mri

ObjectiveIn a proof-of-concept study, to quantify myocardial viability in patients with acute myocardial infarction using manganese-enhanced MRI (MEMRI), a measure of intracellular calcium handling.MethodsHealthy volunteers (n=20) and patients with ST-elevation myocardial infarction (n=20) underwent late gadolinium enhancement (LGE) using gadobutrol and MEMRI using manganese dipyridoxyl diphosphate. Patients were scanned ≤7 days after reperfusion and rescanned after 3 months. Differential manganese uptake was described using a two-compartment model.ResultsAfter manganese administration, healthy control and remote non-infarcted myocardium showed a sustained 25% reduction in T1 values (mean reductions, 288±34 and 281±12 ms). Infarcted myocardium demonstrated less T1 shortening than healthy control or remote myocardium (1157±74 vs 859±36 and 835±28 ms; both p<0.0001) with intermediate T1 values (1007±31 ms) in peri-infarct regions. Compared with LGE, MEMRI was more sensitive in detecting dysfunctional myocardium (dysfunctional fraction 40.5±11.9 vs 34.9%±13.9%; p=0.02) and tracked more closely with abnormal wall motion (r2=0.72 vs 0.55; p<0.0001). Kinetic modelling showed reduced myocardial manganese influx between remote, peri-infarct and infarct regions, enabling absolute discrimination of infarcted myocardium. After 3 months, manganese uptake increased in peri-infarct regions (16.5±3.5 vs 22.8±3.5 mL/100 g/min, p<0.0001), but not the remote (23.3±2.8 vs 23.0±3.2 mL/100 g/min, p=0.8) or infarcted (11.5±3.7 vs 14.0±1.2 mL/100 g/min, p>0.1) myocardium.ConclusionsThrough visualisation of intracellular calcium handling, MEMRI accurately differentiates infarcted, stunned and viable myocardium, and correlates with myocardial dysfunction better than LGE. MEMRI holds major promise in directly assessing myocardial viability, function and calcium handling across a range of cardiac diseases.Trial registration numbersNCT03607669; EudraCT number 2016-003782-25.

scholarly journals Manganese-enhanced MRI of the myocardium

Heart ◽  
2019 ◽  
Vol 105 (22) ◽  
pp. 1695-1700 ◽  
Author(s):  
Nick B Spath ◽  
Gerard Thompson ◽  
Andrew H Baker ◽  
Marc R Dweck ◽  
David E Newby ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Viability ◽  
Imaging Modality ◽  
Mri Contrast Agents ◽  
Calcium Handling ◽  
Contrast Imaging ◽  
Translational Study ◽  
Enhanced Mri ◽  
Ability To Act ◽  
Manganese Enhanced Mri

Gadolinium-based contrast media are widely used in cardiovascular MRI to identify and to highlight the intravascular and extracellular space. After gadolinium, manganese has the second highest paramagnetic moment and was one of the first MRI contrast agents assessed in humans. Over the last 50 years, manganese-enhanced MRI (MEMRI) has emerged as a complementary approach enabling intracellular myocardial contrast imaging that can identify functional myocardium through its ability to act as a calcium analogue. Early progress was limited by its potential to cause myocardial depression. To overcome this problem, two clinical formulations of manganese were developed using either chelation (manganese dipyridoxyl diphosphate) or coadministration with a calcium compound (EVP1001-1, Eagle Vision Pharmaceuticals). Preclinical studies have demonstrated the efficacy of MEMRI in quantifying myocardial infarction and detecting myocardial viability as well as tracking altered contractility and calcium handling in cardiomyopathy. Recent clinical data suggest that MEMRI has exciting potential in the quantification of myocardial viability in ischaemic cardiomyopathy, the early detection of abnormalities in myocardial calcium handling, and ultimately, in the development of novel therapies for myocardial infarction or heart failure by actively quantifying viable myocardium. The stage is now set for wider clinical translational study of this novel and promising non-invasive imaging modality.

scholarly journals Myocardial Viability Imaging using Manganese‐Enhanced MRI in the First Hours after Myocardial Infarction

2021 ◽  
pp. 2003987
Author(s):  
Nur Hayati Jasmin ◽  
May Zaw Thin ◽  
Robert D. Johnson ◽  
Laurence H. Jackson ◽  
Thomas A. Roberts ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Viability ◽  
Enhanced Mri ◽  
Manganese Enhanced Mri ◽  
Viability Imaging

scholarly journals In vivo multi-parametric manganese-enhanced MRI for detecting senile plaques in rodent models of Alzheimer’s disease

2021 ◽  
Author(s):  
Eugene Kim ◽  
Davide Di Censo ◽  
Mattia Baraldo ◽  
Camilla Simmons ◽  
Ilaria Rosa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
High Resolution ◽  
Senile Plaques ◽  
Rodent Models ◽  
Wild Type ◽  
Enhanced Mri ◽  
Manganese Uptake ◽  
5Xfad Mice ◽  
Manganese Enhanced Mri

AbstractSenile plaques are a hallmark of Alzheimer’s disease (AD) that develop in its earliest stages. Thus, non-invasive detection of these plaques would be invaluable for diagnosis and the development and monitoring of treatments, but this remains a challenge due to their small size. Here, we investigated the utility of manganese-enhanced MRI (MEMRI) for visualizing plaques in transgenic rodent models of AD across two species: 5xFAD mice and TgF344-AD rats.Fourteen mice (eight transgenic, six wild-type) and eight rats (four transgenic, four wild-type) were given subcutaneous injections of MnCl2 and imaged in vivo using a 9.4T Bruker scanner. Susceptibility-weighted images, transverse relaxation rate (R2*) maps, and quantitative susceptibility maps were derived from high-resolution 3D multi-gradient-echo (MGE) data to directly visualize plaques. Longitudinal relaxation rate (R1) maps were derived from MP2RAGE data to measure regional manganese uptake. After scanning, the brains were processed for histology and stained for beta-amyloid (4G8 antibody), iron (Perl’s), and calcium/manganese (Alizarin Red).MnCl2 improved signal-to-noise ratio (1.55±0.39-fold increase in MGE images) as expected, although this was not necessary for detection of plaques in the high-resolution images. Plaques were visible in susceptibility-weighted images, R2* maps, and quantitative susceptibility maps, with increased R2* and more positive magnetic susceptibility compared to surrounding tissue.In the 5xFAD mice, most MR-visible plaques were in the hippocampus, though histology confirmed plaques in the cortex and thalamus as well. In the TgF344-AD rats, many more plaques were MR-visible throughout the hippocampus and cortex. Beta-amyloid and iron staining indicate that, in both models, MR visibility was driven by plaque size and iron load.Voxel-wise comparison of R1 maps revealed increased manganese uptake in brain regions of high plaque burden in transgenic animals compared to their wild-type littermates. Interestingly, in contrast to plaque visibility in the high-resolution images, the increased manganese uptake was limited to the rhinencephalon in the TgF344-AD rats (family-wise error (FWE)-corrected p < 0.05) while it was most significantly increased in the cortex of the 5xFAD mice (FWE-corrected p < 0.3). Alizarin Red staining suggests that manganese bound to plaques in 5xFAD mice but not in TgF344-AD rats.Multi-parametric MEMRI is a simple, viable method for detecting senile plaques in rodent models of AD. Manganese-induced signal enhancement can enable higher-resolution imaging, which is key to visualizing these small amyloid deposits. We also present in vivo evidence of manganese as a potential targeted contrast agent for imaging plaques in the 5xFAD model of AD.HighlightsThis is the first study to use manganese-enhanced MRI (MEMRI) for direct visualization of senile plaques in rodent models of Alzheimer’s disease, in vivo.Manganese enhancement is not necessary to detect plaques but improves image contrast and signal-to-noise ratio.Manganese binds to plaques in 5xFAD mice but not in TgF344-AD rats, demonstrating potential as a targeted contrast agent for imaging plaques in certain models of AD.

scholarly journals Myocardial viability of the peri-infarct region measured by T1 mapping post manganese-enhanced MRI correlates with LV dysfunction

2019 ◽  
Vol 281 ◽  
pp. 8-14
Author(s):  
Yuko Tada ◽  
Shahriar Heidary ◽  
Atsushi Tachibana ◽  
Junaid Zaman ◽  
Evgenios Neofytou ◽  
...  
Keyword(s):  
Myocardial Viability ◽  
T1 Mapping ◽  
Infarct Region ◽  
Lv Dysfunction ◽  
Enhanced Mri ◽  
Manganese Enhanced Mri

scholarly journals P773 Can strain imaging predict viability in ST segment elevation myocardial infarction patient

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F Mghaieth Zghal ◽  
S Habboubi ◽  
S Boudiche ◽  
M Ben Halima ◽  
B Rekik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Phase ◽  
Myocardial Viability ◽  
Global Longitudinal Strain ◽  
Reference Method ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Viable Myocardium ◽  
Lv Function ◽  
2D Strain

Abstract Background In the acute phase of ST elevation myocardial infarction (STEMI), the main objective is to recanalize the guilty artery, but it is important to know whether myocardium with severely compromised function is permanently injured or reversibly dysfunctional indicating myocardial viability. On the other hand, viability tests such as scintigraphy, magnetic resonance imaging with delayed enhanced (DE-MRI) or dobutamine stress echography are either not validated or unavailable in the acute phase of STEMI. The assessment of myocardial deformation by bidimensional strain (2D) is a technique that has emerged in recent years with good correlation with MRI for viability assessment. An important question remains : Is myocardial viability can be determined by 2D strain parameters at the acute phase of STEMI ? Aim : To assess myocardial viability in the acute phase of STEMI by 2D strain echocardiographic parameters in comparison with 3 month DE-MRI as a reference method. Methods A total of 31 first STEMI patients treated with successful primary or elective percutaneous coronary intervention (PCI) were included with an akinetic area on echocardiography corresponding to the infarct segments. Doppler strain values from left ventricular basal, mid and apical segments (n= 527) were obtained at the acute phase of STEMI and checked up after 3 months. The scar was assessed for viability by DE-MR as reference method, 3 months after the acute phase. Viability was defined by a DE &lt; 50% of wall thickness in the scar zone. Results Mean age of the study population was 59,29 ±9,96 years , 27 (87%) being males. Nine patients (29%) showed post-PCI improvement of left ventricule (LV) function. Regional peak systolic strain of the infarct segments and global longitudinal strain (GLS) after 3 months. At the acute phase, wall motion score index (WMSI), regional and global strain values were signficantly better in the viable than in the non viable segments. GLS was -10,92 ± 2,48 in patients with MRI non viable myocardium and -14,45 ±2,91 in patients with MRI viable myocardium . A pre-PCI strain value of -2,9% as a cutt off predicted segmental function recovery after PCI and myocardial viability with a sensitivity 82% of and a specificity 84%. Conclusion : This monocenter study confirms that 2D strain imaging can be a usueful and accurate method to predict myocardial viability and recovery of segmental and global LV function after PCI in STEMI patients.

Correlation between oxidative Stress and Alteration of Intracellular Calcium Handling in Isoproterenol-Induced Myocardial Infarction

2006 ◽  
Vol 289 (1-2) ◽  
pp. 125-136 ◽  
Author(s):  
Mauricio Díaz-Muñoz ◽  
Marco Antonio Álvarez-Pérez ◽  
Lucía Yáñez ◽  
Susana Vidrio ◽  
Lidia Martínez ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Myocardial Infarction ◽  
Intracellular Calcium ◽  
Calcium Handling

scholarly journals Actual Problems of Diagnostics of Viable Myocardium

Kardiologiia ◽  
2019 ◽  
Vol 59 (2) ◽  
pp. 68-78 ◽  
Author(s):  
Ya. K. Rustamova
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Viability ◽  
Cardiac Mri ◽  
Myocardial Revascularization ◽  
Viable Myocardium ◽  
Hibernating Myocardium ◽  
Postinfarction Cardiosclerosis ◽  
History Of ◽  
Modern Analysis

The article presents modern analysis of the studies and reflects the key problems concerning the feasibility of performing cardiac MRI for assessment of myocardial viability in patients with history of myocardial infarction (with postinfarction cardiosclerosis), as well as the effectiveness of the method for predicting restoration of the function of hibernating myocardium after myocardial revascularization.

scholarly journals Prognostic Value of Viable Myocardium in Patients with Non-Q-wave and Q-wave Myocardial Infarction

2005 ◽  
Vol 33 (5) ◽  
pp. 574-582 ◽  
Author(s):  
I Baran ◽  
B Ozdemir ◽  
S Gullulu ◽  
AA Kaderli ◽  
T Senturk ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Myocardial Viability ◽  
Prognostic Value ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Viable Myocardium ◽  
Clinical Criteria ◽  
Q Wave

This study assessed the amount and prognostic value of myocardial viability in patients with non-Q-wave myocardial infarction (NQMI) and Q-wave myocardial infarction (QMI). A total of 175 patients with MI and an ejection fraction ≤ 45% underwent dobutamine stress echocardiography. On the basis of clinical criteria and myocardial viability, 110 patients were revascularized. The amount of viable myocardium and the clinical outcome were compared in the NQMI and QMI groups. Patients with NQMI exhibited a larger amount of viable myocardium compared with those with QMI. The mortality rate was 6% in patients with NQMI with viable myocardium and subsequent revascularization, 33% in patients with NQMI without viable myocardium or revascularization, 27% in patients with QMI with viable myocardium and subsequent revascularization, and 33% in patients with QMI without viable myocardium or revascularization. In conclusion, our data suggest that patients with NQMI and viable myocardium have the best prognosis after revascularization.

Sign in / Sign up

Export Citation Format

Share Document