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Sguizzato M, Martini P, Ferrara F, Marvelli L, Drechsler M, Reale G, Calderoni F, Illuminati F, Porto F, Speltri G, Uccelli L, Giganti M, Boschi A, Cortesi R. Manganese-Loaded Liposomes: An In Vitro Study for Possible Diagnostic Application. Molecules 2024; 29:3407. [PMID: 39064985 PMCID: PMC11280348 DOI: 10.3390/molecules29143407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/27/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
The present study investigates the possible use of manganese (Mn)-based liposomal formulations for diagnostic applications in imaging techniques such as magnetic resonance imaging (MRI), with the aim of overcoming the toxicity limitations associated with the use of free Mn2+. Specifically, anionic liposomes carrying two model Mn(II)-based compounds, MnCl2 (MC) and Mn(HMTA) (MH), were prepared and characterised in terms of morphology, size, loading capacity, and in vitro activity. Homogeneous dispersions characterised mainly by unilamellar vesicles were obtained; furthermore, no differences in size and morphology were detected between unloaded and Mn-loaded vesicles. The encapsulation efficiency of MC and MH was evaluated on extruded liposomes by means of ICP-OES analysis. The obtained results showed that both MC and MH are almost completely retained by the lipid portion of liposomes (LPs), with encapsulation efficiencies of 99.7% for MC and 98.8% for MH. The magnetic imaging properties of the produced liposomal formulations were investigated for application in a potential preclinical scenario by collecting magnetic resonance images of a phantom designed to compare the paramagnetic contrast properties of free MC and MH compounds and the corresponding manganese-containing liposome dispersions. It was found that both LP-MC and LP-MH at low concentrations (0.5 mM) show better contrast (contrast-to-noise ratios of 194 and 209, respectively) than solutions containing free Mn at the same concentrations (117 and 134, respectively) and are safe to use on human cells at the selected dose. Taken together, the results of this comparative analysis suggest that these liposome-containing Mn compounds might be suitable for diagnostic purposes.
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Affiliation(s)
- Maddalena Sguizzato
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
- Biotechnology Inter University Consortium (C.I.B.), Ferrara Section, University of Ferrara, 44121 Ferrara, Italy
| | - Petra Martini
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Francesca Ferrara
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
| | - Lorenza Marvelli
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
| | - Markus Drechsler
- Bavarian Polymer Institute Keylab “Electron and Optical Microscopy”, University of Bayreuth, 95447 Bayreuth, Germany;
| | - Giovanni Reale
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (G.R.); (F.P.); (L.U.); (M.G.)
| | | | | | - Francesca Porto
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (G.R.); (F.P.); (L.U.); (M.G.)
| | - Giorgia Speltri
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
| | - Licia Uccelli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (G.R.); (F.P.); (L.U.); (M.G.)
| | - Melchiore Giganti
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (G.R.); (F.P.); (L.U.); (M.G.)
| | - Alessandra Boschi
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
| | - Rita Cortesi
- Department of Chemical, Pharmaceutical and Agricultural Sciences (DoCPAS), University of Ferrara, 44121 Ferrara, Italy; (M.S.); (F.F.); (L.M.); (G.S.); (R.C.)
- Biotechnology Inter University Consortium (C.I.B.), Ferrara Section, University of Ferrara, 44121 Ferrara, Italy
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Singh T, Joshi S, Kershaw LE, Dweck MR, Semple SI, Newby DE. Manganese-Enhanced Magnetic Resonance Imaging of the Heart. J Magn Reson Imaging 2023; 57:1011-1028. [PMID: 36314991 PMCID: PMC10947173 DOI: 10.1002/jmri.28499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 02/23/2023] Open
Abstract
Manganese-based contrast media were the first in vivo paramagnetic agents to be used in magnetic resonance imaging (MRI). The uniqueness of manganese lies in its biological function as a calcium channel analog, thus behaving as an intracellular contrast agent. Manganese ions are taken up by voltage-gated calcium channels in viable tissues, such as the liver, pancreas, kidneys, and heart, in response to active calcium-dependent cellular processes. Manganese-enhanced magnetic resonance imaging (MEMRI) has therefore been used as a surrogate marker for cellular calcium handling and interest in its potential clinical applications has recently re-emerged, especially in relation to assessing cellular viability and myocardial function. Calcium homeostasis is central to myocardial contraction and dysfunction of myocardial calcium handling is present in various cardiac pathologies. Recent studies have demonstrated that MEMRI can detect the presence of abnormal myocardial calcium handling in patients with myocardial infarction, providing clear demarcation between the infarcted and viable myocardium. Furthermore, it can provide more subtle assessments of abnormal myocardial calcium handling in patients with cardiomyopathies and being excluded from areas of nonviable cardiomyocytes and severe fibrosis. As such, MEMRI offers exciting potential to improve cardiac diagnoses and provide a noninvasive measure of myocardial function and contractility. This could be an invaluable tool for the assessment of both ischemic and nonischemic cardiomyopathies as well as providing a measure of functional myocardial recovery, an accurate prediction of disease progression and a method of monitoring treatment response. EVIDENCE LEVEL: 5: TECHNICAL EFFICACY: STAGE 5.
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Affiliation(s)
- Trisha Singh
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh Heart CentreRoyal Infirmary of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
| | - Shruti Joshi
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh Heart CentreRoyal Infirmary of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
| | - Lucy E Kershaw
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
| | - Marc R Dweck
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh Heart CentreRoyal Infirmary of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
| | - Scott I Semple
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
| | - David E Newby
- BHF/University Centre for Cardiovascular ScienceUniversity of EdinburghUK
- Edinburgh Heart CentreRoyal Infirmary of EdinburghUK
- Edinburgh ImagingUniversity of EdinburghUK
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Repeatability and reproducibility of cardiac manganese-enhanced magnetic resonance imaging. Sci Rep 2023; 13:3366. [PMID: 36849509 PMCID: PMC9971197 DOI: 10.1038/s41598-023-29591-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 02/07/2023] [Indexed: 03/01/2023] Open
Abstract
Manganese-enhanced magnetic resonance imaging can provide a surrogate measure of myocardial calcium handling. Its repeatability and reproducibility are currently unknown. Sixty-eight participants: 20 healthy volunteers, 20 with acute myocardial infarction, 18 with hypertrophic and 10 with non-ischemic dilated cardiomyopathy underwent manganese-enhanced magnetic resonance imaging. Ten healthy volunteers were re-scanned at 3 months. Native T1 values and myocardial manganese uptake were assessed for intra and inter-observer repeatability. Scan-rescan reproducibility was assessed in ten healthy volunteers. Intra-observer and inter-observer correlation was excellent in healthy volunteers for mean native T1 mapping [Lin's correlation coefficient (LCC) 0.97 and 0.97 respectively] and myocardial manganese uptake (LCC: 0.99 and 0.96 respectively). Scan-rescan correlation for native T1 and myocardial manganese uptake was also excellent. Similarly, intra-observer correlations for native T1 and myocardial manganese uptake in patients with acute myocardial infarction (LCC: 0.97 and 0.97 respectively), hypertrophic (LCC: 0.98 and 0.97 respectively) and dilated cardiomyopathy (LCC: 0.99 and 0.95 respectively) were excellent. Limits of agreement were broader in patients with dilated cardiomyopathy. Manganese-enhanced magnetic resonance imaging has high repeatability and reproducibility in healthy myocardium and high repeatability in diseased myocardium. However, further study is needed to establish robustness in pathologies with diffuse myocardial fibrosis.
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Singh T, Joshi S, Kershaw LE, Baker AH, McCann GP, Dawson DK, Dweck MR, Semple SI, Newby DE. Manganese-Enhanced Magnetic Resonance Imaging in Takotsubo Syndrome. Circulation 2022; 146:1823-1835. [PMID: 36317524 PMCID: PMC7613919 DOI: 10.1161/circulationaha.122.060375] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Takotsubo syndrome is an acute cardiac emergency characterized by transient left ventricular systolic dysfunction typically following a stressful event. Despite its rapidly rising incidence, its pathophysiology remains poorly understood. Takotsubo syndrome may pass unrecognized, especially if timely diagnostic imaging is not performed. Defective myocardial calcium homeostasis is a central cause of contractile dysfunction and has not been explored in takotsubo syndrome. We aimed to investigate myocardial calcium handling using manganese-enhanced magnetic resonance imaging during the acute and recovery phases of takotsubo syndrome. METHODS Twenty patients with takotsubo syndrome (63±12 years of age; 90% female) and 20 volunteers matched on age, sex, and cardiovascular risk factors (59±11 years of age; 70% female) were recruited from the Edinburgh Heart Centre between March 2020 and October 2021. Patients underwent gadolinium and manganese-enhanced magnetic resonance imaging during index hospitalization with repeat manganese-enhanced magnetic resonance imaging performed after at least 3 months. RESULTS Compared with matched control volunteers, patients had a reduced left ventricular ejection fraction (51±11 versus 67±8%; P<0.001), increased left ventricular mass (86±11 versus 57±14 g/m2; P<0.001), and, in affected myocardial segments, elevated native T1 (1358±49 versus 1211±28 ms; P<0.001) and T2 (60±7 versus 38±3 ms; P<0.0001) values at their index presentation. During manganese-enhanced imaging, kinetic modeling demonstrated a substantial reduction in myocardial manganese uptake (5.1±0.5 versus 8.2±1.1 mL/[100 g of tissue ·min], respectively; P<0.0001), consistent with markedly abnormal myocardial calcium handling. After recovery, left ejection fraction, left ventricular mass, and T2 values were comparable with those of matched control volunteers. Despite this, native and postmanganese T1 and myocardial manganese uptake remained abnormal compared with matched control volunteers (6.6±0.5 versus 8.2±1.1 mL/[100 g of tissue ·min]; P<0.0001). CONCLUSIONS In patients with takotsubo syndrome, there is a profound perturbation of myocardial manganese uptake, which is most marked in the acute phase but persists for at least 3 months despite apparent restoration of normal left ventricular ejection fraction and resolution of myocardial edema, suggesting abnormal myocardial calcium handling may be implicated in the pathophysiology of takotsubo syndrome. Manganese-enhanced magnetic resonance imaging has major potential to assist in the diagnosis, characterization, and risk stratification of patients with takotsubo syndrome. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04623788.
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Affiliation(s)
- Trisha Singh
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, United Kingdom (T.S., S.J., A.H.B., M.R.D., D.E.N.)
| | - Shruti Joshi
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, United Kingdom (T.S., S.J., A.H.B., M.R.D., D.E.N.)
| | - Lucy E Kershaw
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
| | - Andy H Baker
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, United Kingdom (T.S., S.J., A.H.B., M.R.D., D.E.N.)
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, United Kingdom (G.P.M.)
| | - Dana K Dawson
- Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, United Kingdom (D.K.D.)
| | - Marc R Dweck
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, United Kingdom (T.S., S.J., A.H.B., M.R.D., D.E.N.)
| | - Scott I Semple
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
| | - David E Newby
- BHF/University Centre for Cardiovascular Science (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Imaging (T.S., S.J., L.E.K., A.H.B., M.R.D., S.I.S., D.E.N.), University of Edinburgh, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, United Kingdom (T.S., S.J., A.H.B., M.R.D., D.E.N.)
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Lamonzie E, Vaillant F, Abell E, Charron S, El Hamrani D, Quesson B, Brette F. Assessment of Cardiac Toxicity of Manganese Chloride for Cardiovascular Magnetic Resonance. Front Physiol 2022; 13:952043. [PMID: 35874541 PMCID: PMC9302587 DOI: 10.3389/fphys.2022.952043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
MRI is widely used in cardiology to characterize the structure and function of the heart. Currently, gadolinium-based contrast agents are widely used to improve sensitivity and specificity of diagnostic images. Recently, Manganese, a calcium analogue, has emerged as a complementary contrast agent with the potential to reveal remaining viable cells within altered tissue. Imaging applications may be limited by substantial toxicity of manganese. Indeed, cardiac safety of manganese is not yet comprehensively assessed. In this study we investigated the effect of MnCl2 (1–100 µM) on cardiac function. Hemodynamic function was determined ex vivo using an isolated working rat heart preparation. HL-1 cardiac myocytes were used to investigate cell viability (calcein AM) and calcium cycling (Cal-520 a.m.). Rat ventricular cardiomyocytes were dissociated by enzymatic digestion. Action potentials and calcium currents were recorded using the patch clamp technique. MRI experiments were performed at 1.5T on formalin-fixed rat hearts, previously perfused with MnCl2. MnCl2 perfusion from 1 up to 100 µM in isolated working hearts did not alter left ventricular hemodynamic parameters. Contractility and relaxation index were not altered up to 50 µM MnCl2. In HL-1 cardiac myocytes, incubation with increasing concentrations of MnCl2 did not impact cell viability. The amplitude of the calcium transients were significantly reduced at 50 and 100 µM MnCl2. In freshly isolated ventricular myocytes, action potential duration at 20, 50 and 90% of repolarization were not modified up to 10 µM of MnCl2. L-type calcium current amplitude was significantly decreased by 50 and 100 µM of MnCl2. MRI on heart perfused with 25 and 100 µM of MnCl2 showed a dose dependent decrease in the T1 relaxation time. In conclusion, our results show that low concentrations of MnCl2 (up to 25 µM) can be used as a contrast agent in MRI, without significant impact on cardiac hemodynamic or electrophysiology parameters.
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Affiliation(s)
- Elodie Lamonzie
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
| | - Fanny Vaillant
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
| | - Emma Abell
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
| | | | - Dounia El Hamrani
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
| | - Bruno Quesson
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
| | - Fabien Brette
- Univ, Bordeaux, CRCTB, Inserm, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux, France
- *Correspondence: Fabien Brette,
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Martin TP, MacDonald EA, Elbassioni AAM, O'Toole D, Zaeri AAI, Nicklin SA, Gray GA, Loughrey CM. Preclinical models of myocardial infarction: from mechanism to translation. Br J Pharmacol 2021; 179:770-791. [PMID: 34131903 DOI: 10.1111/bph.15595] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 11/28/2022] Open
Abstract
Approximately 7 million people are affected by acute myocardial infarction (MI) each year, and despite significant therapeutic and diagnostic advancements, MI remains a leading cause of mortality worldwide. Preclinical animal models have significantly advanced our understanding of MI and have enabled the development of therapeutic strategies to combat this debilitating disease. Notably, some drugs currently used to treat MI and heart failure (HF) in patients had initially been studied in preclinical animal models. Despite this, preclinical models are limited in their ability to fully reproduce the complexity of MI in humans. The preclinical model must be carefully selected to maximise the translational potential of experimental findings. This review describes current experimental models of MI and considers how they have been used to understand drug mechanisms of action and support translational medicine development.
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Affiliation(s)
- Tamara P Martin
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Eilidh A MacDonald
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Ali Ali Mohamed Elbassioni
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.,Suez Canal University, Arab Republic of Egypt
| | - Dylan O'Toole
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Ali Abdullah I Zaeri
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart A Nicklin
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Gillian A Gray
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Christopher M Loughrey
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
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Spath NB, Singh T, Papanastasiou G, Baker A, Janiczek RJ, McCann GP, Dweck MR, Kershaw L, Newby DE, Semple S. Assessment of stunned and viable myocardium using manganese-enhanced MRI. Open Heart 2021; 8:openhrt-2021-001646. [PMID: 34099530 PMCID: PMC8186753 DOI: 10.1136/openhrt-2021-001646] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/14/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE In 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. METHODS Healthy 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. RESULTS After 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. CONCLUSIONS Through 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 NUMBERS NCT03607669; EudraCT number 2016-003782-25.
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Affiliation(s)
- Nick B Spath
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Trisha Singh
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | | | - Andrew Baker
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | | | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Marc R Dweck
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Lucy Kershaw
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David E Newby
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Scott Semple
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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8
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Bettini S, Bonfrate V, Valli L, Giancane G. Paramagnetic Functionalization of Biocompatible Scaffolds for Biomedical Applications: A Perspective. Bioengineering (Basel) 2020; 7:E153. [PMID: 33260520 PMCID: PMC7711469 DOI: 10.3390/bioengineering7040153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 01/15/2023] Open
Abstract
The burst of research papers focused on the tissue engineering and regeneration recorded in the last years is justified by the increased skills in the synthesis of nanostructures able to confer peculiar biological and mechanical features to the matrix where they are dispersed. Inorganic, organic and hybrid nanostructures are proposed in the literature depending on the characteristic that has to be tuned and on the effect that has to be induced. In the field of the inorganic nanoparticles used for decorating the bio-scaffolds, the most recent contributions about the paramagnetic and superparamagnetic nanoparticles use was evaluated in the present contribution. The intrinsic properties of the paramagnetic nanoparticles, the possibility to be triggered by the simple application of an external magnetic field, their biocompatibility and the easiness of the synthetic procedures for obtaining them proposed these nanostructures as ideal candidates for positively enhancing the tissue regeneration. Herein, we divided the discussion into two macro-topics: the use of magnetic nanoparticles in scaffolds used for hard tissue engineering for soft tissue regeneration.
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Affiliation(s)
- Simona Bettini
- Department of Innovation Engineering, University Campus Ecotekne, University of Salento, Via per Monteroni, 73100 Lecce, Italy;
- National Interuniversity Consortium of Materials Science and Technology, INSTM, Via G. Giusti, 9, 50121 Firenze, Italy
| | - Valentina Bonfrate
- Department of Cultural Heritage, University of Salento, via D. Birago, 64, 73100 Lecce, Italy;
| | - Ludovico Valli
- National Interuniversity Consortium of Materials Science and Technology, INSTM, Via G. Giusti, 9, 50121 Firenze, Italy
- Department of Biological and Environmental Sciences and Technology (DiSTeBA), University Campus Ecotekne, University of Salento, Via per Monteroni, 73100 Lecce, Italy
| | - Gabriele Giancane
- National Interuniversity Consortium of Materials Science and Technology, INSTM, Via G. Giusti, 9, 50121 Firenze, Italy
- Department of Cultural Heritage, University of Salento, via D. Birago, 64, 73100 Lecce, Italy;
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Spath NB, Singh T, Papanastasiou G, Kershaw L, Baker AH, Janiczek RL, Gulsin GS, Dweck MR, McCann G, Newby DE, Semple SI. Manganese-enhanced magnetic resonance imaging in dilated cardiomyopathy and hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020:jeaa273. [PMID: 33200175 DOI: 10.1093/ehjci/jeaa273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/17/2020] [Indexed: 01/07/2023] Open
Abstract
AIMS The aim of this study is to quantify altered myocardial calcium handling in non-ischaemic cardiomyopathy using magnetic resonance imaging. METHODS AND RESULTS Patients with dilated cardiomyopathy (n = 10) or hypertrophic cardiomyopathy (n = 17) underwent both gadolinium and manganese contrast-enhanced magnetic resonance imaging and were compared with healthy volunteers (n = 20). Differential manganese uptake (Ki) was assessed using a two-compartment Patlak model. Compared with healthy volunteers, reduction in T1 with manganese-enhanced magnetic resonance imaging was lower in patients with dilated cardiomyopathy [mean reduction 257 ± 45 (21%) vs. 288 ± 34 (26%) ms, P < 0.001], with higher T1 at 40 min (948 ± 57 vs. 834 ± 28 ms, P < 0.0001). In patients with hypertrophic cardiomyopathy, reductions in T1 were less than healthy volunteers [mean reduction 251 ± 86 (18%) and 277 ± 34 (23%) vs. 288 ± 34 (26%) ms, with and without fibrosis respectively, P < 0.001]. Myocardial manganese uptake was modelled, rate of uptake was reduced in both dilated and hypertrophic cardiomyopathy in comparison with healthy volunteers (mean Ki 19 ± 4, 19 ± 3, and 23 ± 4 mL/100 g/min, respectively; P = 0.0068). In patients with dilated cardiomyopathy, manganese uptake rate correlated with left ventricular ejection fraction (r2 = 0.61, P = 0.009). Rate of myocardial manganese uptake demonstrated stepwise reductions across healthy myocardium, hypertrophic cardiomyopathy without fibrosis and hypertrophic cardiomyopathy with fibrosis providing absolute discrimination between the healthy myocardium and fibrosed myocardium (mean Ki 23 ± 4, 19 ± 3, and 13 ± 4 mL/100 g/min, respectively; P < 0.0001). CONCLUSION The rate of manganese uptake in both dilated and hypertrophic cardiomyopathy provides a measure of altered myocardial calcium handling. This holds major promise for the detection and monitoring of dysfunctional myocardium, with the potential for early intervention and prognostication.
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Affiliation(s)
- N B Spath
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SB, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - T Singh
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SB, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - G Papanastasiou
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - L Kershaw
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - A H Baker
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
| | - R L Janiczek
- Department of Clinical Imaging, GlaxoSmithKline, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK
| | - G S Gulsin
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - M R Dweck
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SB, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - G McCann
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - D E Newby
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SB, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - S I Semple
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SA, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, EH16 4TJ, UK
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Kwiecinski J, Lennen RJ, Gray GA, Borthwick G, Boswell L, Baker AH, Newby DE, Dweck MR, Jansen MA. Progression and regression of left ventricular hypertrophy and myocardial fibrosis in a mouse model of hypertension and concomitant cardiomyopathy. J Cardiovasc Magn Reson 2020; 22:57. [PMID: 32758255 PMCID: PMC7409657 DOI: 10.1186/s12968-020-00655-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 07/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Myocardial fibrosis is observed in multiple cardiac conditions including hypertension and aortic stenosis. Excessive fibrosis is associated with adverse clinical outcomes, but longitudinal human data regarding changes in left ventricular remodelling and fibrosis over time are sparse because of the slow progression, thereby making longitudinal studies challenging. The purpose of this study was to establish and characterize a mouse model to study the development and regression of left ventricular hypertrophy and myocardial fibrosis in response to increased blood pressure and to understand how these processes reverse remodel following normalisation of blood pressure. METHODS We performed a longitudinal study with serial cardiovascular magnetic resonance (CMR) imaging every 2 weeks in mice (n = 31) subjected to angiotensin II-induced hypertension for 6 weeks and investigated reverse remodelling following normalisation of afterload beyond 6 weeks (n = 9). Left ventricular (LV) volumes, mass, and function as well as myocardial fibrosis were measured using cine CMR and the extracellular volume fraction (ECV) s. RESULTS Increased blood pressure (65 ± 12 vs 85 ± 9 mmHg; p < 0.001) resulted in higher indices of LV hypertrophy (0.09 [0.08, 0.10] vs 0.12 [0.11, 0.14] g; p < 0.001) and myocardial fibrosis (ECV: 0.24 ± 0.03 vs 0.30 ± 0.02; p < 0.001) whilst LV ejection fraction fell (LVEF, 59.3 [57.6, 59.9] vs 46.9 [38.5, 49.6] %; p < 0.001). We found a strong correlation between ECV and histological myocardial fibrosis (r = 0.89, p < 0.001). Following cessation of angiotensin II and normalisation of blood pressure (69 ± 5 vs baseline 65 ± 12 mmHg; p = 0.42), LV mass (0.11 [0.10, 0.12] vs 0.09 [0.08, 0.11] g), ECV (0.30 ± 0.02 vs 0.27 ± 0.02) and LVEF (51.1 [42.9, 52.8] vs 59.3 [57.6, 59.9] %) improved but remained impaired compared to baseline (p < 0.05 for all). There was a strong inverse correlation between LVEF and %ECV during both systemic hypertension (r = - 0.88, p < 0.001) and the increases in ECV observed in the first two weeks of increased blood pressure predicted the reduction in LVEF after 6 weeks (r = - 0.77, p < 0.001). CONCLUSIONS We have established and characterized angiotensin II infusion and repeated CMR imaging as a model of LV hypertrophy and reverse remodelling in response to systemic hypertension. Changes in myocardial fibrosis and alterations in cardiac function are only partially reversible following relief of hypertension.
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Affiliation(s)
- Jacek Kwiecinski
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Ross J Lennen
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Gillian A Gray
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Gary Borthwick
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Lyndsey Boswell
- Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Andrew H Baker
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - David E Newby
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Maurits A Jansen
- Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
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