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Jasmin NH, Thin MZ, Johnson RD, Jackson LH, Roberts TA, David AL, Lythgoe MF, Yang PC, Davidson SM, Camelliti P, Stuckey DJ. Myocardial Viability Imaging using Manganese-Enhanced MRI in the First Hours after Myocardial Infarction. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2003987. [PMID: 34105284 PMCID: PMC8188227 DOI: 10.1002/advs.202003987] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/08/2021] [Indexed: 05/19/2023]
Abstract
Early measurements of tissue viability after myocardial infarction (MI) are essential for accurate diagnosis and treatment planning but are challenging to obtain. Here, manganese, a calcium analogue and clinically approved magnetic resonance imaging (MRI) contrast agent, is used as an imaging biomarker of myocardial viability in the first hours after experimental MI. Safe Mn2+ dosing is confirmed by measuring in vitro beating rates, calcium transients, and action potentials in cardiomyocytes, and in vivo heart rates and cardiac contractility in mice. Quantitative T1 mapping-manganese-enhanced MRI (MEMRI) reveals elevated and increasing Mn2+ uptake in viable myocardium remote from the infarct, suggesting MEMRI offers a quantitative biomarker of cardiac inotropy. MEMRI evaluation of infarct size at 1 h, 1 and 14 days after MI quantifies myocardial viability earlier than the current gold-standard technique, late-gadolinium-enhanced MRI. These data, coupled with the re-emergence of clinical Mn2+ -based contrast agents open the possibility of using MEMRI for direct evaluation of myocardial viability early after ischemic onset in patients.
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Affiliation(s)
- Nur Hayati Jasmin
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
- School of Medical ImagingFaculty of Health SciencesUniversiti Sultan Zainal AbidinKuala Terengganu21300Malaysia
| | - May Zaw Thin
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
| | - Robert D. Johnson
- School of Biosciences and MedicineUniversity of SurreyGuildfordGU2 7XHUK
| | - Laurence H. Jackson
- School of Biomedical Engineering & Imaging SciencesKing's College LondonLondonSE1 7EHUK
| | - Thomas A. Roberts
- School of Biomedical Engineering & Imaging SciencesKing's College LondonLondonSE1 7EHUK
| | - Anna L. David
- UCL Elizabeth Garrett Anderson Institute for Women's HealthLondonWC1E 6BTUK
| | - Mark F. Lythgoe
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
| | - Philip C. Yang
- Division of Cardiovascular MedicineDepartment of MedicineStanford UniversityStanfordCA94305USA
| | - Sean M. Davidson
- The Hatter Cardiovascular InstituteUniversity College London67 Chenies MewsLondonWC1E 6HXUK
| | - Patrizia Camelliti
- School of Biosciences and MedicineUniversity of SurreyGuildfordGU2 7XHUK
| | - Daniel J. Stuckey
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
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Spath NB, Thompson G, Baker AH, Dweck MR, Newby DE, Semple SIK. Manganese-enhanced MRI of the myocardium. Heart 2019; 105:1695-1700. [PMID: 31337670 PMCID: PMC6855794 DOI: 10.1136/heartjnl-2019-315227] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 01/12/2023] Open
Abstract
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.
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Affiliation(s)
- Nick B Spath
- BHF/University Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Gerard Thompson
- Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Andrew H Baker
- BHF/University Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| | - Marc R Dweck
- BHF/University Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - David E Newby
- BHF/University Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Scott I K Semple
- BHF/University Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
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Spath NB, Lilburn DML, Gray GA, Le Page LM, Papanastasiou G, Lennen RJ, Janiczek RL, Dweck MR, Newby DE, Yang PC, Jansen MA, Semple SI. Manganese-Enhanced T 1 Mapping in the Myocardium of Normal and Infarcted Hearts. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:9641527. [PMID: 30498403 PMCID: PMC6222240 DOI: 10.1155/2018/9641527] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/23/2018] [Accepted: 07/29/2018] [Indexed: 02/01/2023]
Abstract
Background Manganese-enhanced MRI (MEMRI) has the potential to identify viable myocardium and quantify calcium influx and handling. Two distinct manganese contrast media have been developed for clinical application, mangafodipir and EVP1001-1, employing different strategies to mitigate against adverse effects resulting from calcium-channel agonism. Mangafodipir delivers manganese ions as a chelate, and EVP1001-1 coadministers calcium gluconate. Using myocardial T1 mapping, we aimed to explore chelated and nonchelated manganese contrast agents, their mechanism of myocardial uptake, and their application to infarcted hearts. Methods T1 mapping was performed in healthy adult male Sprague-Dawley rats using a 7T MRI scanner before and after nonchelated (EVP1001-1 or MnCl2 (22 μmol/kg)) or chelated (mangafodipir (22-44 μmol/kg)) manganese-based contrast media in the presence of calcium channel blockade (diltiazem (100-200 μmol/kg/min)) or sodium chloride (0.9%). A second cohort of rats underwent surgery to induce anterior myocardial infarction by permanent coronary artery ligation or sham surgery. Infarcted rats were imaged with standard gadolinium delayed enhancement MRI (DEMRI) with inversion recovery techniques (DEMRI inversion recovery) as well as DEMRI T1 mapping. A subsequent MEMRI scan was performed 48 h later using either nonchelated or chelated manganese and T1 mapping. Finally, animals were culled at 12 weeks, and infarct size was quantified histologically with Masson's trichrome (MTC). Results Both manganese agents induced concentration-dependent shortening of myocardial T1 values. This was greatest with nonchelated manganese, and could be inhibited by 30-43% with calcium-channel blockade. Manganese imaging successfully delineated the area of myocardial infarction. Indeed, irrespective of the manganese agent, there was good agreement between infarct size on MEMRI T1 mapping and histology (bias 1.4%, 95% CI -14.8 to 17.1 P>0.05). In contrast, DEMRI inversion recovery overestimated infarct size (bias 11.4%, 95% CI -9.1 to 31.8 P=0.002), as did DEMRI T1 mapping (bias 8.2%, 95% CI -10.7 to 27.2 P=0.008). Increased manganese uptake was also observed in the remote myocardium, with remote myocardial ∆T1 inversely correlating with left ventricular ejection fraction after myocardial infarction (r=-0.61, P=0.022). Conclusions MEMRI causes concentration and calcium channel-dependent myocardial T1 shortening. MEMRI with T1 mapping provides an accurate assessment of infarct size and can also identify changes in calcium handling in the remote myocardium. This technique has potential applications for the assessment of myocardial viability, remodelling, and regeneration.
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Affiliation(s)
- N. B. Spath
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - D. M. L. Lilburn
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - G. A. Gray
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - L. M. Le Page
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - G. Papanastasiou
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - R. J. Lennen
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Preclinical Imaging, University of Edinburgh, Edinburgh, UK
| | - R. L. Janiczek
- GlaxoSmithKline, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - M. R. Dweck
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - D. E. Newby
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - P. C. Yang
- Department of Cardiology, Stanford University, Stanford, CA, USA
| | - M. A. Jansen
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Preclinical Imaging, University of Edinburgh, Edinburgh, UK
| | - S. I. Semple
- British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Jiang K, Tang H, Mishra PK, Macura SI, Lerman LO. A rapid T 1 mapping method for assessment of murine kidney viability using dynamic manganese-enhanced magnetic resonance imaging. Magn Reson Med 2018; 80:190-199. [PMID: 29193339 PMCID: PMC5876081 DOI: 10.1002/mrm.27025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/09/2017] [Accepted: 11/01/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Dynamic manganese-enhanced MRI (MEMRI) allows assessment of tissue viability by tracing manganese uptake. We aimed to develop a rapid T1 mapping method for dynamic MEMRI to facilitate assessments of murine kidney viability. METHODS A multi-slice saturation recovery fast spin echo (MSRFSE) was developed, validated, and subsequently applied in dynamic MEMRI at 16.4T on ischemic mouse kidneys after 4 weeks of unilateral renal artery stenosis (RAS). Baseline T1 values and post-contrast R1 (1/T1 ) changes were measured in cortex (CO), outer (OSOM), inner (ISOM) strips of outer medulla, and inner medulla (IM). RESULTS Validation studies showed strong agreement between MSRFSE and an established saturation recovery Look-Locker method. Baseline T1 (s) increased in the stenotic kidney CO (2.10 [1.95-2.56] vs. 1.88 [1.81-2.00], P = 0.0317) and OSOM (2.17 [2.05-2.33] vs. 1.96 [1.87-2.00], P = 0.0075) but remained unchanged in ISOM and IM. This method allowed a temporal resolution of 1.43 min in dynamic MEMRI. Mn2+ uptake and retention decreased in stenotic kidneys, particularly in the OSOM (ΔR1 : 0.48 [0.38-0.56] vs. 0.64 [0.61-0.69] s-1 , P < 0.0001). CONCLUSION Dynamic MEMRI by MSRFSE detected decreased cellular viability and discerned the regional responses to RAS. This technique may provide a valuable tool for noninvasive evaluation of renal viability. Magn Reson Med 80:190-199, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Kai Jiang
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Hui Tang
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Prassana K. Mishra
- Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Slobodan I. Macura
- Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Lilach O. Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
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Tachibana A. [6. Application of MRI Technology to the Regenerative Medicine in Heart Disease Using Induced Pluripotent Stem Cells]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:491-498. [PMID: 29780049 DOI: 10.6009/jjrt.2018_jsrt_74.5.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tachibana A, Santoso MR, Mahmoudi M, Shukla P, Wang L, Bennett M, Goldstone AB, Wang M, Fukushi M, Ebert AD, Woo YJ, Rulifson E, Yang PC. Paracrine Effects of the Pluripotent Stem Cell-Derived Cardiac Myocytes Salvage the Injured Myocardium. Circ Res 2017; 121:e22-e36. [PMID: 28743804 DOI: 10.1161/circresaha.117.310803] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 01/06/2023]
Abstract
RATIONALE Cardiac myocytes derived from pluripotent stem cells have demonstrated the potential to mitigate damage of the infarcted myocardium and improve left ventricular ejection fraction. However, the mechanism underlying the functional benefit is unclear. OBJECTIVE To evaluate whether the transplantation of cardiac-lineage differentiated derivatives enhance myocardial viability and restore left ventricular ejection fraction more effectively than undifferentiated pluripotent stem cells after a myocardial injury. Herein, we utilize novel multimodality evaluation of human embryonic stem cells (hESCs), hESC-derived cardiac myocytes (hCMs), human induced pluripotent stem cells (iPSCs), and iPSC-derived cardiac myocytes (iCMs) in a murine myocardial injury model. METHODS AND RESULTS Permanent ligation of the left anterior descending coronary artery was induced in immunosuppressed mice. Intramyocardial injection was performed with (1) hESCs (n=9), (2) iPSCs (n=8), (3) hCMs (n=9), (4) iCMs (n=14), and (5) PBS control (n=10). Left ventricular ejection fraction and myocardial viability, measured by cardiac magnetic resonance imaging and manganese-enhanced magnetic resonance imaging, respectively, was significantly improved in hCM- and iCM-treated mice compared with pluripotent stem cell- or control-treated mice. Bioluminescence imaging revealed limited cell engraftment in all treated groups, suggesting that the cell secretions may underlie the repair mechanism. To determine the paracrine effects of the transplanted cells, cytokines from supernatants from all groups were assessed in vitro. Gene expression and immunohistochemistry analyses of the murine myocardium demonstrated significant upregulation of the promigratory, proangiogenic, and antiapoptotic targets in groups treated with cardiac lineage cells compared with pluripotent stem cell and control groups. CONCLUSIONS This study demonstrates that the cardiac phenotype of hCMs and iCMs salvages the injured myocardium effectively than undifferentiated stem cells through their differential paracrine effects.
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Affiliation(s)
- Atsushi Tachibana
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Michelle R Santoso
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Morteza Mahmoudi
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Praveen Shukla
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Lei Wang
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Mihoko Bennett
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Andrew B Goldstone
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Mouer Wang
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Masahiro Fukushi
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Antje D Ebert
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Y Joseph Woo
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Eric Rulifson
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.)
| | - Phillip C Yang
- From the Division of Cardiovascular Medicine (A.T., M.R.S., M.M., P.S., L.W., M.W., A.D.E., E.R., P.C.Y.), Division of Neonatal and Developmental Medicine (M.B.), and Department of Cardiothoracic Surgery (A.B.G., Y.J.W.), Stanford University, CA; Department of Radiological Sciences, Tokyo Metropolitan University, Japan (A.T., M.F.); Department of Critical Care Medicine, 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, China (L.W.); Department of Cardiology and Pneumonology, Göttingen University Medical Center, Germany (A.D.E.); and German Center for Cardiovascular Research, Partner Site Göttingen, Germany (A.D.E.).
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Telmisartan in the diabetic murine model of acute myocardial infarction: dual contrast manganese-enhanced and delayed enhancement MRI evaluation of the peri-infarct region. Cardiovasc Diabetol 2016; 15:24. [PMID: 26846539 PMCID: PMC4743104 DOI: 10.1186/s12933-016-0348-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/28/2016] [Indexed: 12/26/2022] Open
Abstract
Background
A novel MRI technique, employing dual contrast manganese-enhanced MRI (MEMRI) and delayed enhancement MRI (DEMRI), can evaluate the physiologically unstable peri-infarct region. Dual contrast MEMRI–DEMRI enables comprehensive evaluation of telmisartan to salvage the peri-infarct injury to elucidate the underlying mechanism of restoring the ischemic cardiomyopathy in the diabetic mouse model. Methods and results Dual contrast MEMRI–DEMRI was performed on weeks 1, 2, and 4 following initiation of telmisartan treatment in 24 left anterior descendent artery ligated diabetic mice. The MRI images were analyzed for core infarct, peri-infarct, left ventricular end-diastolic, end-systolic volumes, and the left ventricular ejection fraction (LVEF). Transmission electron microscopy (TEM) and real-time PCR were used for ex vivo analysis of the myocardium. Telmisartan vs. control groups demonstrated significantly improved LVEF at weeks 1, 2, and 4, respectively (33 ± 7 %*** vs. 19 ± 5 %, 29 ± 3 %*** vs. 22 ± 4 %, and 31 ± 2 %*** vs 18 ± 6 %, ***p < 0.001). The control group demonstrated significant differences in the scar volume measured by MEMRI and DEMRI, demonstrating peri-infarct injury. Telmisartan group significantly salvaged the peri-infarct injury. The myocardial effects were validated by TEM, which confirmed the presence of the injured but viable cardiomyocyte morphology in the peri-infarct region and by flow cytometry of venous blood, which demonstrated significantly increased circulating endothelial progenitor cells (EPCs). Conclusion The improved cardiac function in ischemic cardiomyopathy of diabetic mice by telmisartan is attributed to the attenuation of the peri-infarct injury by the angiogenic effects of EPCs to salvage the injured cardiomyocytes. Dual-contrast MEMRI–DEMRI technique tracked the therapeutic effects of telmisartan on the injured myocardium longitudinally.
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Dash R, Kim PJ, Matsuura Y, Ikeno F, Metzler S, Huang NF, Lyons JK, Nguyen PK, Ge X, Foo CWP, McConnell MV, Wu JC, Yeung AC, Harnish P, Yang PC. Manganese-Enhanced Magnetic Resonance Imaging Enables In Vivo Confirmation of Peri-Infarct Restoration Following Stem Cell Therapy in a Porcine Ischemia-Reperfusion Model. J Am Heart Assoc 2015. [PMID: 26215972 PMCID: PMC4608088 DOI: 10.1161/jaha.115.002044] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The exact mechanism of stem cell therapy in augmenting the function of ischemic cardiomyopathy is unclear. In this study, we hypothesized that increased viability of the peri-infarct region (PIR) produces restorative benefits after stem cell engraftment. A novel multimodality imaging approach simultaneously assessed myocardial viability (manganese-enhanced magnetic resonance imaging [MEMRI]), myocardial scar (delayed gadolinium enhancement MRI), and transplanted stem cell engraftment (positron emission tomography reporter gene) in the injured porcine hearts. Methods and Results Twelve adult swine underwent ischemia–reperfusion injury. Digital subtraction of MEMRI-negative myocardium (intrainfarct region) from delayed gadolinium enhancement MRI–positive myocardium (PIR and intrainfarct region) clearly delineated the PIR in which the MEMRI-positive signal reflected PIR viability. Human amniotic mesenchymal stem cells (hAMSCs) represent a unique population of immunomodulatory mesodermal stem cells that restored the murine PIR. Immediately following hAMSC delivery, MEMRI demonstrated an increased PIR viability signal compared with control. Direct PIR viability remained higher in hAMSC-treated hearts for >6 weeks. Increased PIR viability correlated with improved regional contractility, left ventricular ejection fraction, infarct size, and hAMSC engraftment, as confirmed by immunocytochemistry. Increased MEMRI and positron emission tomography reporter gene signal in the intrainfarct region and the PIR correlated with sustained functional augmentation (global and regional) within the hAMSC group (mean change, left ventricular ejection fraction: hAMSC 85±60%, control 8±10%; P<0.05) and reduced chamber dilatation (left ventricular end-diastole volume increase: hAMSC 24±8%, control 110±30%; P<0.05). Conclusions The positron emission tomography reporter gene signal of hAMSC engraftment correlates with the improved MEMRI signal in the PIR. The increased MEMRI signal represents PIR viability and the restorative potential of the injured heart. This in vivo multimodality imaging platform represents a novel, real-time method of tracking PIR viability and stem cell engraftment while providing a mechanistic explanation of the therapeutic efficacy of cardiovascular stem cells.
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Affiliation(s)
- Rajesh Dash
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
| | - Paul J Kim
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | - Yuka Matsuura
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | - Fumiaki Ikeno
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | - Scott Metzler
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | - Ngan F Huang
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
| | - Jennifer K Lyons
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | - Patricia K Nguyen
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
| | - Xiaohu Ge
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | | | - Michael V McConnell
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Department of Electrical Engineering, Stanford University, Stanford, CA (M.V.M.C.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
| | - Joseph C Wu
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
| | - Alan C Yeung
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.)
| | | | - Phillip C Yang
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.D., P.J.K., Y.M., F.I., S.M., N.F.H., J.K.L., P.K.N., X.G., M.V.M.C., J.C.W., A.C.Y., P.C.Y.) Stanford Cardiovascular Institute, Stanford University, Stanford, CA (R.D., N.F.H., P.K.N., M.V.M.C., J.C.W., P.C.Y.)
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Antkowiak PF, Stevens BK, Nunemaker CS, McDuffie M, Epstein FH. Manganese-enhanced magnetic resonance imaging detects declining pancreatic β-cell mass in a cyclophosphamide-accelerated mouse model of type 1 diabetes. Diabetes 2013; 62:44-8. [PMID: 22933107 PMCID: PMC3526033 DOI: 10.2337/db12-0153] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Currently, there is no ideal noninvasive method to quantify the progressive loss of pancreatic β-cell mass (BCM) that occurs in type 1 diabetes. Magnetic resonance imaging has detected gross differences in BCM between healthy and diabetic mice using the contrast agent manganese, which labels functional β-cells and increases the water proton relaxation rate (R1), but its ability to measure gradations in BCM during disease progression is unknown. Our objective was to test the hypothesis that measurements of the manganese-enhanced pancreatic R1 could detect decreasing BCM in a mouse model of type 1 diabetes. We used cyclophosphamide-accelerated BDC2.5 T-cell receptor transgenic nonobese diabetic mice, which experience development of type 1 diabetes during a 7-day time period after cyclophosphamide injection, whereas transgene-negative mice do not. We measured the manganese-enhanced pancreatic R1 before cyclophosphamide injection (day 0) and on days 3, 4, 5, and 7 afterward. Pancreatic R1 remained constant in transgene-negative mice and decreased stepwise day-to-day in transgene-positive mice, mirroring their loss of BCM, confirmed by pancreatic insulin measurements and histology. Changes in R1 in transgene-positive mice occurred before elevations in blood glucose, a clinical indicator of diabetes, suggesting potential for early noninvasive detection of changes in functional BCM.
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Affiliation(s)
- Patrick F. Antkowiak
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Brian K. Stevens
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia
| | - Craig S. Nunemaker
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Marcia McDuffie
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Frederick H. Epstein
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
- Department of Radiology, University of Virginia, Charlottesville, Virginia
- Corresponding author: Frederick H. Epstein,
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10
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Dash R, Chung J, Ikeno F, Hahn-Windgassen A, Matsuura Y, Bennett MV, Lyons JK, Teramoto T, Robbins RC, McConnell MV, Yeung AC, Brinton TJ, Harnish PP, Yang PC. Dual manganese-enhanced and delayed gadolinium-enhanced MRI detects myocardial border zone injury in a pig ischemia-reperfusion model. Circ Cardiovasc Imaging 2011; 4:574-82. [PMID: 21719779 DOI: 10.1161/circimaging.110.960591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gadolinium (Gd)-based delayed-enhancement MRI (DEMRI) identifies nonviable myocardium but is nonspecific and may overestimate nonviable territory. Manganese (Mn(2+))-enhanced MRI (MEMRI) denotes specific Mn(2+) uptake into viable cardiomyocytes. We performed a dual-contrast myocardial assessment in a porcine ischemia-reperfusion (IR) model to test the hypothesis that combined DEMRI and MEMRI identifies viable infarct border zone (BZ) myocardium in vivo. METHODS AND RESULTS Sixty-minute left anterior descending coronary artery IR injury was induced in 13 adult swine. Twenty-one days post-IR, 3-T cardiac MRI was performed. MEMRI was obtained after injection of 0.7 mL/kg Mn(2+) contrast agent. DEMRI was then acquired after injection of 0.2 mmol/kg Gd. Left ventricular (LV) mass, infarct, and function were analyzed. Subtraction of MEMRI defect from DEMRI signal identified injured BZ myocardium. Explanted hearts were analyzed by 2,3,5-triphenyltetrazolium chloride stain and tissue electron microscopy to compare infarct, BZ, and remote myocardium. Average LV ejection fraction was reduced (30±7%). MEMRI and DEMRI infarct volumes correlated with 2,3,5-triphenyltetrazolium chloride stain analysis (MEMRI, r=0.78; DEMRI, r=0.75; P<0.004). MEMRI infarct volume percentage was significantly lower than that of DEMRI (14±4% versus 23±4%; P<0.05). BZ MEMRI signal-to-noise ratio (SNR) was intermediate to remote and core infarct SNR (7.5±2.8 versus 13.2±3.4 and 2.9±1.6; P<0.0001), and DEMRI BZ SNR tended to be intermediate to remote and core infarct SNR (8.4±5.4 versus 3.3±0.6 and 14.3±6.6; P>0.05). Tissue electron microscopy analysis exhibited preserved cell structure in BZ cardiomyocytes despite transmural DEMRI enhancement. CONCLUSIONS The dual-contrast MEMRI-DEMRI detects BZ viability within DEMRI infarct zones. This approach may identify injured, at-risk myocardium in ischemic cardiomyopathy.
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Affiliation(s)
- Rajesh Dash
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA 94305-5233, USA.
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11
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Fernandes JL, Storey P, da Silva JA, de Figueiredo GS, Kalaf JM, Coelho OR. Preliminary assessment of cardiac short term safety and efficacy of manganese chloride for cardiovascular magnetic resonance in humans. J Cardiovasc Magn Reson 2011; 13:6. [PMID: 21235750 PMCID: PMC3032736 DOI: 10.1186/1532-429x-13-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 01/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Manganese based agents are intracellular and accumulate inside myocytes allowing for different imaging strategies compared to gadolinium contrasts. While previous agents release manganese very slowly in the circulation, MnCl2 allows for rapid Mn2+ uptake in myocytes, creating a memory effect that can be potentially explored. Data on animal models are very encouraging but the safety and efficacy of this approach in humans has not yet been investigated. Therefore, our objectives were to study the safety and efficacy of a rapid infusion of manganese chloride (MnCl2) for cardiovascular magnetic resonance (CMR) in humans. METHODS Fifteen healthy volunteers underwent a CMR scan on a 1.5 T scanner. Before the infusion, cardiac function was calculated and images of a short axis mid-ventricular slice were obtained using a 2D and 3D gradient-echo inversion recovery (GRE-IR) sequence, a phase-sensitive IR sequence and a single breath-hold segmented IR prepared steady-state precession acquisition for T1 calculations. MnCl2 was infused over three minutes at a total dose of 5 μMol/kg. Immediately after the infusion, and at 15 and 30 minutes later, new images were obtained and cardiac function re-evaluated. RESULTS There was a significant decrease in T1 values compared to baseline, sustained up to 30 minutes after the MnCl2 infusion (pre,839 ± 281 ms; 0 min, 684 ± 99; 15 min, 714 ± 168; 30 min, 706 ± 172, P = 0.003). The 2D and 3D GRE-IR sequence showed the greatest increase in signal-to-noise ratio compared to the other sequences (baseline 6.6 ± 4.2 and 9.7 ± 5.3; 0 min, 11.3 ± 4.1 and 15.0 ± 8.7; 15 min, 10.8 ± 4.0 and 16.9 ± 10.2; 30 min, 10.6 ± 5.2 and 16.5 ± 8.3, P < 0.001 for both). There was a slight increase in systolic pressure and heart rate after three and four minutes of the infusion with normalization of these parameters thereafter. Patients showed good tolerance to MnCl2 with no major adverse events, despite all reporting transient facial flush. CONCLUSIONS In the short term, MnCl2 appears safe for human use. It effectively decreases myocardium T1, maintaining this effect for a relatively long period of time and allowing for the development of new imaging strategies in CMR, especially in ischemia research.
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Affiliation(s)
- Juliano L Fernandes
- Department of Internal Medicine - University of Campinas - Unicamp - R. Antonio Lapa 1032 - Campinas - Brazil
| | - Pippa Storey
- Center for Biomedical Imaging - New York University - 660 First Avenue 4th floor - New York - USA
| | - Jose Alvaro da Silva
- Department of Radiology - Radiologia Clinica de Campinas - Av Jose de Souza Campos 870 - Campinas - Brazil
| | - Gabriel S de Figueiredo
- Department of Radiology - Radiologia Clinica de Campinas - Av Jose de Souza Campos 870 - Campinas - Brazil
| | - Jose M Kalaf
- Department of Radiology - Radiologia Clinica de Campinas - Av Jose de Souza Campos 870 - Campinas - Brazil
| | - Otavio R Coelho
- Department of Internal Medicine - University of Campinas - Unicamp - R. Antonio Lapa 1032 - Campinas - Brazil
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12
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Abstract
The use of manganese ions (Mn(2+)) as an MRI contrast agent was introduced over 20 years ago in studies of Mn(2+) toxicity in anesthetized rats (1). Manganese-enhanced MRI (MEMRI) evolved in the late nineties when Koretsky and associates pioneered the use of MEMRI for brain activity measurements (2) as well as neuronal tract tracing (3). Currently, MEMRI has three primary applications in biological systems: (1) contrast enhancement for anatomical detail, (2) activity-dependent assessment and (3) tracing of neuronal connections or tract tracing. MEMRI relies upon the following three main properties of Mn(2+): (1) it is a paramagnetic ion that shortens the spin lattice relaxation time constant (T(1)) of tissues, where it accumulates and hence functions as an excellent T(1) contrast agent; (2) it is a calcium (Ca(2+)) analog that can enter excitable cells, such as neurons and cardiac cells via voltage-gated Ca(2+) channels; and (3) once in the cells Mn(2+) can be transported along axons by microtubule-dependent axonal transport and can also cross synapses trans-synaptically to neighboring neurons. This chapter will emphasize the methodological approaches towards the use of MEMRI in biological systems.
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Affiliation(s)
- Cynthia A Massaad
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, USA.
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13
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Hu TCC, Chuang KH, Yanasak N, Koretsky A. Relationship between blood and myocardium manganese levels during manganese-enhanced MRI (MEMRI) with T1 mapping in rats. NMR IN BIOMEDICINE 2011; 24:46-53. [PMID: 20665900 PMCID: PMC4213145 DOI: 10.1002/nbm.1554] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Manganese ions (Mn(2+) ) enter viable myocardial cells via voltage-gated calcium channels. Because of its shortening of T(1) and its relatively long half-life in cells, Mn(2+) can serve as an intracellular molecular contrast agent to study indirect calcium influx into the myocardium. One major concern in using Mn(2+) is its sensitivity over a limited range of concentrations employing T(1)-weighted images for visualization, which limits its potential in quantitative techniques. Therefore, this study assessed the implementation of a T(1) mapping method for cardiac manganese-enhanced MRI to enable a quantitative estimate of the influx of Mn(2+) over a wide range of concentrations in male Sprague-Dawley rats. This MRI method was used to compare the relationship between T(1) changes in the heart as a function of myocardium and blood Mn(2+) levels. Results showed a biphasic relationship between ΔR(1) and the total Mn(2+) infusion dose. Nonlinear relationships were observed between the total Mn(2+) infusion dose versus blood levels and left ventricular free wall ΔR(1) . At low blood levels of Mn(2+) , there was proportionally less cardiac enhancement seen than at higher levels of blood Mn(2+) . We hypothesize that Mn(2+) blood levels increase as a result of rate-limiting excretion by the liver and kidneys at these higher Mn(2+) doses.
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Affiliation(s)
- Tom C-C Hu
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA.
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14
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Hansen RH. CMR2009: 3.01: High temporal-resolution contrast-enhanced dynamic scanning using MnCl 2. CONTRAST MEDIA & MOLECULAR IMAGING 2009. [DOI: 10.1002/cmmi.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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A modified rabbit model of reperfused myocardial infarction for cardiac MR imaging research. Int J Cardiovasc Imaging 2008; 25:289-98. [PMID: 19043805 DOI: 10.1007/s10554-008-9393-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Accepted: 11/10/2008] [Indexed: 12/16/2022]
Abstract
We sought to obtain a rabbit myocardial infarction (MI) model for research with cardiac magnetic resonance imaging (cMRI) by overcoming a few technical difficulties. A novel endotracheal method was developed for intubation and ventilation. Fourteen rabbits were divided into group-1 (n = 8) with open-chest occlusion of left circumflex coronary artery and closed-chest reperfusion, and group-2 (n = 6) of non-ischemic control; and received ECG-triggered cMRI with delayed contrast enhancement (DE-cMRI) at a 1.5 T clinical scanner. The MI areas in group-1 were morphometrically compared between DE-cMRI and histochemically stained specimens. Left ventricular (LV) functions were compared between two groups.The success rate of intubation and reperfused MI was 8/8 and 6/8, respectively. Global and regional LV functions significantly decreased in group-1 as evidenced by significant hypokinesis of lateral LV-wall and wall thickening (P \ 0.001). Mean MI-area was 19.41 +/- 21.92% on DE-cMRI and 19.10 +/- 22.61% with histochemical staining (r = 0.985). Global MI-volume was 17.92 +/- 7.42% on DE-cMRI and 16.62 +/- 7.16% with histochemistry (r = 0.994). The usefulness of this model was successfully tested for assessing a new contrast agent. The present rabbit MI model may offer a practical platform for more translational research using clinical MRI-facilities.
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Waghorn B, Edwards T, Yang Y, Chuang KH, Yanasak N, Hu TCC. Monitoring dynamic alterations in calcium homeostasis by T (1)-weighted and T (1)-mapping cardiac manganese-enhanced MRI in a murine myocardial infarction model. NMR IN BIOMEDICINE 2008; 21:1102-1111. [PMID: 18780285 DOI: 10.1002/nbm.1287] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Manganese has been used as a T(1)-weighted MRI contrast agent in a variety of applications. Because manganese ions (Mn(2+)) enter viable myocardial cells via voltage-gated Ca(2+) channels, manganese-enhanced MRI is sensitive to the viability and inotropic state of the heart. In spite of the established importance of Ca(2+) regulation in the heart both before and after myocardial injury, monitoring strategies to assess Ca(2+) homeostasis in affected cardiac tissues are limited. This study implements a T(1)-mapping method to obtain quantitative information both dynamically and over a range of MnCl(2) infusion doses. To optimize the current Mn(2+) infusion protocols, we performed both dose-dependent and temporal washout studies. A non-linear relationship between infused MnCl(2) solution dose and increase in left ventricular wall relaxation rate (DeltaR(1)) was observed. Control mice also exhibited significant Mn(2+) clearance over time, with a decrease in DeltaR(1) of approximately 50% occurring in just 2.5 h. The complicated efflux time dependence possibly suggests multiple efflux mechanisms. With the use of the measured relationship between infused Mn(2+) dose, DeltaR(1), and inductively coupled plasma mass spectrometry data analysis provided a means of estimating the absolute heart Mn concentration in vivo. We show that this technique has the sensitivity to observe or monitor potential alterations in Ca(2+) handling in vivo because of the physiological remodeling after myocardial infarction. Left ventricular free wall DeltaR(1) values were significantly lower (P = 0.005) in the adjacent zone, surrounding the injured myocardial tissue, than in healthy tissue. This inferred reduction in Mn concentration can be used to estimate potentially salvageable myocardium in vivo for future treatment or evaluation of disease progression.
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Affiliation(s)
- Ben Waghorn
- Small Animal Imaging, Department of Radiology, Medical College of Georgia, Augusta, GA 30912, USA
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Arbab AS, Liu W, Frank JA. Cellular magnetic resonance imaging: current status and future prospects. Expert Rev Med Devices 2006; 3:427-39. [PMID: 16866640 DOI: 10.1586/17434440.3.4.427] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cellular magnetic resonance imaging (CMRI) allows for the tracking of the temporal and spatial migration of cells labeled with MR contrast agents within organs and tissues. This rapidly growing area of experimental research has the potential of translating from bench to bedside and may be used in conjunction with cellular therapy clinical trials or in the evaluation of novel drug therapies. Ex vivo labeling of nonphagocytic cells with superparamagnetic iron oxide nanoparticles or paramagnetic contrast agents (i.e., gadolinium or manganese) allows for the detection of single cells or clusters of labeled cells within target tissues using CMRI following either direct implantation or intravenous injection. However, prior to the translation of experimental cell labeling studies to clinical trials, it is essential to perform preclinical evaluation to demonstrate a lack of toxicity, the ability to scale-up labeling using good manufacturing practice and the ability to detect cells by in vivo MRI in relevant model systems.
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Affiliation(s)
- Ali S Arbab
- Henry Ford Health System, Radiology Research, Detroit, MI 48202, USA.
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