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Acute infarct selective MRI contrast agent

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Abstract

To determine the infarct affinity of a low molecular weight contrast agent, Gd(ABE-DTTA), during the subacute phase of myocardial infarct (MI). Dogs (n = 7) were examined, using a closed-chest, reperfused MI model. MI was generated by occluding for 180 min the Left Anterior Descending (LAD) coronary artery with an angioplasty balloon. DE-MRI images with Gd(ABE-DTTA) were obtained on days 4, 14, and 28 after MI. Control DE-MRI by Gd(DTPA) was carried out on day 27. T2-TSE images were acquired on day 3, 13 and 27. Triphenyltetrazolium chloride (TTC) histomorphometry validated postmortem the existence of infarct. Gd(ABE-DTTA) highlighted the infarct on day 4, but not at all on day 14 or on day 28, following MI. On day 4, the mean ± SD signal intensity (SI) of infarcted myocardium in the presence of Gd(ABE-DTTA) significantly differed from that of healthy myocardium (45 ± 6.0 vs. 10 ± 5.0, P < 0.05), but it did not on day 14 (11 ± 9.4 vs. 10 ± 5.7, P = NS), nor on day 28 (7 ± 1.5 vs. 7 ± 2.4, P = NS). The mean ± SD signal intensity enhancement (SIE) induced by Gd(ABE-DTTA) was 386 ± 165% on day 4, significantly different from mean SIE on day 14 (9 ± 20%), and from mean SIE on day 28 (12 ± 18%), following MI (P < 0.05). The last two mean values did not differ significantly (P = NS) from each other. As control, Gd(DTPA) was used and it did highlight the infarct on day 27, inducing a mean SIE value of 312 ± 40%. The mean SIE on day 3, 13, or 27 did not vary significantly (P = NS) on the T2-TSE images (114 ± 41%, 123 ± 41%, and 150 ± 79%, respectively). Post mortem, the existence of infarcts was confirmed by TTC staining. The infarct affinity of Gd(ABE-DTTA) vanishes in the subacute phase of scar healing, allowing its use for infarct age differentiation early on, immediately following the acute phase.

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Acknowledgments

This study was partially supported by National Institutes of Health; Grant Number: 1R41 HL084844. An abstract of this work was presented at the 38th Annual Meeting of the North American Society of Cardiovascular Imaging (NASCI), October 3-5, 2010 Seattle, Washington. A part of this work (the clinical implications paragraphs in the Discussion section) was presented at the 59th Annual Scientific Session of the American College of Cardiology, March 2010, Atlanta, Georgia.

Conflict of interests

Dr. Kirschner and Dr. Varga-Szemes are employees, P. Kiss, P. Suranyi and B. Ruzsics were employees, and Drs. A. Elgavish and G. A. Elgavish are officers, of Elgavish Paramagnetics Inc., as well as employees of UAB.

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Authors and Affiliations

  1. Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, MCLM 556, Birmingham, AL, 35294-0005, USA

    Robert Kirschner, Akos Varga-Szemes, Tamas Simor, Pal Suranyi, Pal Kiss, Balazs Ruzsics & Gabriel A. Elgavish

  2. Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Brigitta C. Brott

  3. Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Ada Elgavish

  4. Heart Institute, Faculty of Medicine, University of Pecs, Pecs, Hungary

    Robert Kirschner, Akos Varga-Szemes & Tamas Simor

  5. Elgavish Paramagnetics Inc., Birmingham, AL, USA

    Robert Kirschner, Akos Varga-Szemes, Tamas Simor, Pal Suranyi, Pal Kiss, Balazs Ruzsics, Ada Elgavish & Gabriel A. Elgavish

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  1. Robert Kirschner
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  2. Akos Varga-Szemes
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Correspondence to Gabriel A. Elgavish.

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Kirschner, R., Varga-Szemes, A., Simor, T. et al. Acute infarct selective MRI contrast agent. Int J Cardiovasc Imaging 28, 285–293 (2012). https://doi.org/10.1007/s10554-011-9811-8

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