Emerging MRI techniques for molecular and functional phenotyping of the diseased heart

Abstract

Recent advances in cardiac MRI (CMR) capabilities have truly transformed its potential for deep phenotyping of the diseased heart. Long known for its unparalleled soft tissue contrast and excellent depiction of three-dimensional (3D) structure, CMR now boasts a range of unique capabilities for probing disease at the tissue and molecular level. We can look beyond coronary vessel blockages and detect vessel disease not visible on a structural level. We can assess if early fibrotic tissue is being laid down in between viable cardiac muscle cells. We can measure deformation of the heart wall to determine early presentation of stiffening. We can even assess how cardiomyocytes are utilizing energy, where abnormalities are often precursors to overt structural and functional deficits. Finally, with artificial intelligence gaining traction due to the high computing power available today, deep learning has proven itself a viable contender with traditional acceleration techniques for real-time CMR. In this review, we will survey five key emerging MRI techniques that have the potential to transform the CMR clinic and permit early detection and intervention. The emerging areas are: (1) imaging microvascular dysfunction, (2) imaging fibrosis, (3) imaging strain, (4) imaging early metabolic changes, and (5) deep learning for acceleration. Through a concerted effort to develop and translate these areas into the CMR clinic, we are committing ourselves to actualizing early diagnostics for the most intractable heart disease phenotypes.

Proteomic Analysis in Valvular Cardiomyopathy: Aortic Regurgitation vs. Aortic Stenosis

“…We were able to detect an enrichment of protein clusters commonly associated with early stages of CHF (e.g., enhanced proteasome activity, reduced mitochondrial capacity) which may reflect efforts of the LV myocardium to compensate for subtle remodeling processes. Eventually, our findings and results of further subsequent translational research (e.g., correlating findings from proteomics studies and emerging cardiac magnetic resonance imaging techniques for functional and molecular phenotyping, such as feature-tracking strain analysis to visualize and assess subclinical myocardial dysfunction and 31-phosphorus magnetic resonance spectroscopy to visualize and assess early changes in cardiac muscle energy metabolism [ 35 ]) could potentially serve as a reference for identification of biomarkers for determination of disease stage.…”

GSTM2 alleviates heart failure by inhibiting DNA damage in cardiomyocytes

“…The atria are mainly responsible for collecting and transferring pulmonary and systemic blood, and ventricles are responsible for pumping blood throughout the entire body [ 29 ]. Consistent with their functions, mitochondrial proteins and lipid metabolism-related proteins were more abundant in healthy ventricles than in atria [ 11 ].…”

Review of cardiac–coronary interaction and insights from mathematical modeling

“…For example, cardiomyocyte swelling and interstitial edema in response to ischemia can compress the intramural vessels and contribute to no‐reflow phenomenon (Bouleti et al, 2015; Rezkalla & Kloner, 2002). More studies utilizing advanced perfusion high‐resolution imaging techniques such as positron emission tomography combined with high‐resolution functional and metabolic imaging of the myocardium using cardiac magnetic resonance imaging can help provide insights into how cardiac–coronary interactions contribute to blood flow spatial heterogeneity in the myocardium (Cheng, 2022; van de Weijer et al, 2018).…”