Recent advances in molecular imaging have permitted the noninvasive imaging of apoptosis, a critical process underlying the pathogenesis of many diseases of the cardiovascular system including atherosclerotic vascular disease, myocardial ischemia and reperfusion injury, chronic heart failure, myocarditis, and cardiac allograft rejection. Multiple molecular targets including phosphatidylserine, phosphatidylinositol 3-kinase, and caspases have been targeted by a variety of imaging agents and modalities such as nuclear scintigraphy, PET, MRI, and fluorescent and bioluminescent imaging. Translationally, methods utilizing radiolabeled annexin V have proven promising in several clinical trials of ischemia-reperfusion injury and cardiac allograft rejection. New approaches using novel molecular imaging agents show great potential for the ability to image apoptosis in the research and clinical setting. Ultimately the ability to detect apoptosis noninvasively would help to identify patients for emerging anti-apoptotic therapies and guide clinical management with the aim of maximal myocardial preservation.
KeywordsNoninvasive imaging; Molecular imaging; Apoptosis; Cardiovascular; Annexin Cardiomyocyte apoptosis underlies the pathogenesis of many diseases of the cardiovascular system including atherosclerotic vascular disease, myocardial ischemia and reperfusion injury, Correspondence to: David Edwin Sosnovik.
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Author ManuscriptHeart Fail Rev. Author manuscript; available in PMC 2008 December 8.
Published in final edited form as:Heart Fail Rev. 2008 June ; 13(2): 163-173. doi:10.1007/s10741-007-9068-4.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript chronic heart failure, myocarditis, and cardiac allograft rejection. In the past decade, noninvasive methods to image molecular aspects of apoptosis have grown rapidly and are now offering a wealth of information in both the biological and clinical arenas. In this review, we highlight recent advances in noninvasive molecular imaging of apoptosis in cardiovascular disease.
Molecular imagingMolecular imaging is an emerging field that utilizes injectable imaging agents or genetically encoded reporters to assay key cells and molecules involved in a biological process of interest. While similar imaging hardware platforms can be utilized (e.g. nuclear scintigraphy, magnetic resonance imaging, optical imaging), information gleaned from molecular imaging studies is complementary to details obtained from structural and/or physiological imaging methods. As a comprehensive review of imaging agent and hardware technology is beyond the scope of this review, the interested reader is referred to several recent articles on molecular imaging in general [1][2][3], and the cardiovascular system [4][5][6][7][8][9].
Apoptosis biologyThe biology of apoptosis offers a roadmap for the development and discussion of apoptosisimaging strategies. In contrast to necrosis, apoptosis is a highly regulated, ATP-dependent, noninflammatory process resulting in f...