Image-guided therapies for myocardial repair: concepts and practical implementation

Area of Science:

• Regenerative medicine
• Cardiovascular imaging
• Biomedical engineering

Background:

• Cell- and molecule-based therapies are emerging for myocardial infarction (MI) recovery.
• These therapies aim to preserve ventricular function by enhancing tissue repair post-ischaemia/reperfusion.
• Effective therapeutic development requires guidance on timing, targeting, selection, and monitoring.

Purpose of the Study:

• To review the role of non-invasive tomographic imaging in guiding novel MI therapies.
• To propose an integrated imaging approach for optimizing tissue repair strategies.
• To establish a framework for developing effective regenerative therapies for MI.

Main Methods:

• Review of current literature on cell/molecule-based therapies for MI.
• Analysis of structural imaging techniques (MRI, CT) for infarct assessment.
• Evaluation of radionuclide imaging for molecular mechanism interrogation and agent tracking.

Main Results:

• Structural imaging (MRI, CT) quantifies infarct size, tissue characteristics, muscle mass, and geometry.
• Radionuclide imaging tracks therapeutic agents and assesses molecular processes (inflammation, angiogenesis, ECM activation).
• An integrated imaging approach provides crucial guidance for therapy development.

Conclusions:

• Early, integrated implementation of structural and molecular tomographic imaging is hypothesized to be key.
• This approach will provide a framework for achieving improved tissue repair after MI.
• Optimized imaging guidance is essential for the successful development of regenerative therapies for myocardial infarction.