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Manganese dipyridoxyl-diphosphate (MnDPDP) as a viability marker in patients with myocardial infarction
Arne Skjold1, Brage H Amundsen, Rune Wiseth
1Department of Circulation and Medical Imaging (ISB), Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Arne.Skjold@stolav.no
Purpose:
To evaluate contrast accumulation in left ventricular (LV) myocardium after manganese dipyridoxyl-diphosphate (MnDPDP) administration in patients with recent first time myocardial infarction.
Materials And Methods:
MnDPDP (5 micromol/kg) was administered to 10 patients with recent myocardial infarction (three to 12 weeks). One slice of interest (SOI) likely to traverse the infarction was chosen, and sectorial pre- and postcontrast longitudinal relaxivity rates (R(1)) and signal changes during infusion were estimated with a fast gradient echo sequence. LV volume and wall thickening were measured in short-axis cine recordings. Infarct localization from R(1) and wall thickening data were compared by vector analyses.
Results:
Reduced wall thickening was associated with reduced precontrast R(1) and reduced contrast enhancement. Both remote and infarcted regions showed rapid initial contrast accumulation. In remote regions, this was followed by a continuing slow increase. Mean precontrast R(1) was 0.87 +/- 0.06 second(-1) in infarcted regions and 0.96 +/- 0.03 second(-1) in remote regions (P < 0.001). Mean R(1) change over one hour was 0.24 +/- 0.07 second(-1) in infarcted regions and 0.38 +/- 0.03 second(-1) in remote regions (P < 0.0001).
Conclusion:
Remote regions showed larger increases in R(1) than infarcted regions. This is most likely due to selective and slow Mn accumulation in viable myocytes.
Insights
Manganese dipyridoxyl-diphosphate (MnDPDP) showed differential contrast accumulation in the heart after myocardial infarction. Viable heart muscle (remote regions) accumulated more contrast than infarcted areas, indicating selective manganese uptake.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Biomedical Engineering
Background:
- Myocardial infarction (MI) can lead to significant changes in left ventricular (LV) myocardium.
- Assessing myocardial viability and function post-MI is crucial for patient management.
- Novel contrast agents are being investigated for cardiovascular magnetic resonance imaging (CMR).
Purpose of the Study:
- To evaluate contrast accumulation in the left ventricular (LV) myocardium.
- To assess the behavior of manganese dipyridoxyl-diphosphate (MnDPDP) after myocardial infarction.
- To correlate contrast enhancement patterns with myocardial function.
Main Methods:
- MnDPDP was administered to 10 patients with recent myocardial infarction.
- Longitudinal relaxivity rates (R(1)) and signal changes were measured using fast gradient echo sequences.
- LV volume and wall thickening were assessed, and infarct localization was compared using vector analyses.
Main Results:
- Reduced myocardial wall thickening correlated with reduced precontrast R(1) and contrast enhancement.
- Both infarcted and remote regions showed rapid initial MnDPDP accumulation.
- Remote regions exhibited a slower, sustained increase in R(1) compared to infarcted regions.
Conclusions:
- Remote myocardial regions demonstrated greater increases in R(1) than infarcted regions.
- This suggests selective and slow manganese accumulation in viable myocytes.
- MnDPDP shows potential for differentiating viable from infarcted myocardium post-MI.
