Cardiac MR imaging of hemorrhagic reperfusion injury after myocardial infarction

心肌梗死后出血性再灌注损伤的心脏磁共振成像

• 批准号: 9890855
• 负责人: Walter R.T. Witschey
• 金额: $ 54.61万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9890855
• 关键词: 3-Dimensional; Acute myocardial infarction; Affect; Animals; Arrhythmia; Biocompatible Materials; Blood flow; Cardiac; Cessation of life; Clinical; Complication; Coronary; Coupled; Data; Deposition; Development; Edema; Evolution; Extracellular Matrix; Family suidae; Fibrosis; Generations; Goals; Health; Healthcare; Heart failure; Hemorrhage; High Prevalence; Histologic; Histology; Image; Imaging Techniques; Immunofluorescence Immunologic; Impairment; Implantable Defibrillators; Incidence; Infarction; Injury; Iron; Ischemia; Knowledge; Left Ventricular Function; Left Ventricular Remodeling; Magnetic Resonance Imaging; Magnetism; Maps; Measures; Medical; Methods; Modeling; Morbidity - disease rate; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocardial tissue; Myocardium; Patients; Phase; Physiologic pulse; Plasma; Predisposition; Preventive; Property; Relaxation; Reperfusion Injury; Reperfusion Therapy; Research Personnel; Risk; Risk stratification; Severities; Signal Transduction; Specificity; Stains; Study of magnetics; Techniques; Testing; Time; Tissues; Ventricular Remodeling; Work; aggressive therapy; emission spectroscopy; experimental study; heart imaging; high risk population; imaging modality; improved; in vivo; interest; mortality; non-invasive imaging; novel; percutaneous coronary intervention; pre-clinical; respiratory; restoration; stem cells; success; tool

PROJECT SUMMARY Heart failure (HF) is an enormous health burden affecting approximately 5.1 million people in the US and is the cause of 250,000 deaths each year. Approximately 50% of HF is caused by myocardial ischemia and requires immediate restoration of coronary blood flow to the affected myocardium. However, the success of reperfusion is partly limited by intramyocardial hemorrhage, which is the deposition of intravascular material into the myocardium. Hemorrhagic reperfusion injury has high prevalence and patients have a much greater risk of adverse left ventricular remodeling, risk of fatal arrhythmia, impaired systolic function and are hospitalized at a greater rate. Recent magnetic resonance imaging techniques have improved assessment of reperfusion injury, however, the association between MRI contrasts and reperfusion injury is highly unclear, and lacks specificity to IMH. Improved imaging of IMH and accurate knowledge about its spatial and temporal evolution may be essential for delivery of optimal medical therapy in patients and critical to identify patients most at risk for adverse ventricular remodeling. The overall goal is to investigate the magnetic properties of hemorrhage and develop MRI techniques with improved specificity to hemorrhage. New MRI techniques permit noninvasive assessment of the magnetic susceptibility of tissues and can target tissue iron. Therefore, we hypothesize that MRI imaging of myocardial magnetic susceptibility can map hemorrhagic myocardium. We will perform preclinical experiments in a pig model of reperfusion injury to validate these methods, compare them with conventional MR contrasts and develop MR methods for imaging live animals.

项目摘要 心力衰竭（HF）是一个巨大的健康负担，影响了美国约510万人，是 每年死亡250,000人。大约50％的HF是由心肌缺血引起的，需要 立即恢复受影响心肌的冠状动脉血流。但是，再灌注的成功 部分受到心肌内出血的限制，这是血管内材料的沉积 心肌。出血再灌注损伤的患病率很高，患者的风险更大 不良左心室重塑，致命心律不齐的风险，收缩功能受损，并在 更高的速度。最近的磁共振成像技术改善了再灌注损伤的评估， 但是，MRI对比与再灌注损伤之间的关联尚不清楚，并且缺乏特异性 到IMH。改善IMH的成像以及有关其空间和时间演变的准确知识可能是 对于患者提供最佳药物治疗至关重要，至关重要的是确定最有可能的患者 不良心室重塑。总体目标是研究出血的磁性和 开发MRI技术，提高了出血的特异性。新的MRI技术允许无创 评估组织的磁敏感性，并可以靶向组织铁。因此，我们假设 心肌磁化率的MRI成像可以映射出血性心肌。我们将表演 在拟验证这些方法的猪模型中进行临床前实验，将其与 常规的MR对比并开发MR方法来成像活动物。