Molecular imaging of cardiac remodelling after myocardial infarction

Abstract

Myocardial infarction and subsequent heart failure is a major health burden associated with significant mortality and morbidity in western societies. The ability of cardiac tissue to recover after myocardial infarction is affected by numerous complex cellular and molecular pathways. Unbalance or failure of these pathways can lead to adverse remodelling of the heart and poor prognosis. Current clinical cardiac imaging modalities assess anatomy, perfusion, function, and viability of the myocardium, yet do not offer any insight into the specific molecular pathways involved in the repair process. Novel imaging techniques allow visualisation of these molecular processes and may have significant diagnostic and prognostic values, which could aid clinical management. Single photon-emission tomography, positron-emission tomography, and magnetic resonance imaging are used to visualise various aspects of these molecular processes. Imaging probes are usually attached to radioisotopes or paramagnetic nanoparticles to specifically target biological processes such as: apoptosis, necrosis, inflammation, angiogenesis, and scar formation. Although the results from preclinical studies are promising, translating this work to a clinical environment in a valuable and cost-effective way is extremely challenging. Extensive evaluation evidence of diagnostic and prognostic values in multi-centre clinical trials is still required.

Molecular Imaging to Monitor Left Ventricular Remodeling in Heart Failure

“…Cardiovascular diseases (CVD) are the leading cause of death worldwide and consist of a variety of diseases from cardiac dysfunction to aneurysm rupture [1][2][3]. In this review, we describe how novel imaging techniques including magnetic resonance imaging (MRI), hyperpolarized MRI (hMRI), positron-emission tomography (PET), and single photon-emission computed tomography (SPECT) techniques can be used to image myocardial infarction (MI) and myocardial remodeling post-MI.…”

“…Intense fibrosis leads to scar formation [7••, 8-11], which further changes the shape and function of the left ventricle (LV) and can be manifested as dilation and thinning of the myocardium, hypertrophy of the remote areas surrounding MI, and overall decline of the heart function ( Fig. 1) [3,[12][13][14]. All of these features can be accessed by kinematic imaging over the heart cycle [3].…”

“…1) [3,[12][13][14]. All of these features can be accessed by kinematic imaging over the heart cycle [3].…”

“…To image heart function, ultrasound and computed tomography (CT) are applied besides the above mentioned techniques [3,15,16]. Nuclear medicine imaging techniques, namely PET and SPECT, are used to measure changes in perfusion, metabolism, and molecular pathways at the cellular level during the remodeling [3]. Tracer molecule owing a capability to bind into defined receptor or other molecule steers radionuclide or other compound which enhances image contrast into target tissue [17].…”

Rat Left Ventricular Cardiomyocytes Characterization in the Process of Postinfarction Myocardial Remodeling

“…Despite significant increase in ploidy levels of CMC, the most important factor of myocardial growth in mammals after birth is their hypertrophy . It was suggested, that the enhancement of the functional activity of the myocardium or its regeneration after damage mostly proceed by intracellular regeneration, associated with the increase in the number of organelles and various intracellular structures . According to an alternative viewpoint , the heart has a high capacity to CMCs repopulation owing to the resident or circulating stem cells.…”