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Molecular imaging of myocardial infarction

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Abstract

Myocardial infarction (MI), and subsequent heart failure, remains a major healthcare problem in the western and developing world and leads to substantial morbidity and mortality. After MI, the ability of the myocardium to recover is closely associated with a complex immune response that often leads to adverse remodeling of the ventricle, and poor prognosis. Currently used clinical imaging modalities allow the assessment of anatomy, perfusion, function, and viability but do not provide insights into specific biological processes. In contrast, novel non-invasive imaging methods, using targeted imaging agents, allow imaging of the molecular processes underlying the post-MI immune cell response, and subsequent remodeling. Therefore, this may have significant diagnostic, prognostic, and therapeutic value, and may help to improve our understanding of post-infarct remodeling, in vivo. Imaging modalities such as magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography have been used in concert with radiolabelled and (super) paramagnetic probes to image each phase of the immune response. These probes, which target apoptosis, necrosis, neutrophils, monocytes, enzymes, angiogenesis, extracellular matrix, and scar formation have been assessed and validated pre-clinically. Translating this work to the bedside in a cost-effective, clinically beneficial manner remains a significant challenge. This article reviews these new imaging techniques as well as the corresponding pathophysiology.

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Authors and Affiliations

  1. Division of Imaging Sciences and Biomedical Engineering, King’s College London, St. Thomas’ Hospital, 4th Floor, Lambeth Wing, London, SE1 7EH, UK

    Naheed Jivraj, Alkystis Phinikaridou & René M. Botnar

  2. Cardiovascular Division, King’s College London, London, UK

    Ajay M. Shah

  3. Wellcome Trust and ESPRC Medical Engineering Center, King’s College London, London, UK

    Alkystis Phinikaridou & René M. Botnar

  4. BHF Centre of Excellence, Cardiovascular Division, King’s College London, London, UK

    Alkystis Phinikaridou, Ajay M. Shah & René M. Botnar

  5. NIHR Biomedical Research Centre, King’s College London, London, UK

    Ajay M. Shah & René M. Botnar

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  1. Naheed Jivraj
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  2. Alkystis Phinikaridou
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  3. Ajay M. Shah
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  4. René M. Botnar
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Correspondence to René M. Botnar.

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Jivraj, N., Phinikaridou, A., Shah, A.M. et al. Molecular imaging of myocardial infarction. Basic Res Cardiol 109, 397 (2014). https://doi.org/10.1007/s00395-013-0397-2

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