Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Khan, Jamal Nasir; McCann, Gerry P

doi:10.4330/wjc.v9.i2.109

Cited by 34 publications

(35 citation statements)

References 202 publications

(292 reference statements)

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“…ESVi decreased in IGF-1 MSPs group over the 10 weeks period, while it increased slightly in CON and remained stable in MSPs. These results, especially the one´s found in the IGF-1 MSPs group, agree with data described in literature that indicate that EDVi increases, ESVi decreases and compensatory hypertrophy of the remote myocardium are common findings after MI in order to preserve stroke volume and LVEF 44 .…”

Section: Discussionsupporting

confidence: 92%

“…Thus, in this preclinical investigation, we used CMR for morphological and functional evaluation of the heart. This imaging technique is widely recommended for the assessment of IS and cardiac function [40][41][42][43][44] and offers a variety of parameters potentially suited as surrogate end-points in clinical studies 45 . In clinical research the most relevant parameter for assessing heart function is LVEF 42,43 .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, a statistically significant decrease over time in this parameter was observed in the three groups. This reduction in the percentage of infarction, including CON and MSPs groups, could be attributed to an overestimation in that parameter in the earliest phases of infarction due to the presence of inflammation, haemorrhage and edema 44,[50][51][52] . Likewise, the decrease in IS at 10 weeks could be explained by the degree of LV wall thinning due to ventricular remodelling resulting in a loss of cardiomyocytes, destruction of the extracellular matrix of the necrotic area and its replacement by a fibrotic scar 53,54 .…”

Section: Discussionmentioning

confidence: 99%

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Microencapsulated Insulin-Like Growth Factor-1 therapy improves cardiac function and reduces fibrosis in a porcine acute myocardial infarction model

Báez-Díaz

Blanco-Blázquez

Sánchez-Margallo

et al. 2020

Sci Rep

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Insulin-like growth factor-1 (IGF-1) has demonstrated beneficial effects after myocardial infarction (MI). Microencapsulation of IGF-1 could potentially improve results. We aimed to test the effect of an intracoronary (IC) infusion of microencapsulated IGF-1 in a swine acute MI model. For that purpose IC injection of a 10 ml solution of 5 × 10 6 IGF-1 loaded microspheres (MSPs) (n = 8, IGF-1 MSPs), 5 × 10 6 unloaded MSPs (n = 9; MSPs) or saline (n = 7; CON) was performed 48 hours post-MI. Left ventricular ejection fraction (LVEF), indexed ventricular volumes and infarct size (IS) were determined by cardiac magnetic resonance at pre-injection and 10 weeks. Animals were euthanized at 10 weeks, and myocardial fibrosis and vascular density were analysed. End-study LVEF was significantly greater in IGF-1 MSPs compared to MSPs and CON, while ventricular volumes exhibited no significant differences between groups. IS decreased over time in all groups. Collagen volume fraction on the infarct area was significantly reduced in IGF-1 MSPs compared to CON and MSPs. Vascular density analysis of infarct and border zones showed no significant differences between groups. In conclusion, the IC injection of 5 × 10 6 IGF-1 loaded MSPs in a porcine acute MI model successfully improves cardiac function and limits myocardial fibrosis, which could be clinically relevant.Cardiovascular diseases, especially ischemic heart disease, are the leading cause of mortality worldwide accounting for almost 4 million deaths a year in Europe 1,2 . Conventional treatments such as angioplasty and coronary stenting have contributed to reduce early mortality after an acute myocardial infarction (MI) 3 . However, such therapies are only palliative and do not recover the damaged myocardial tissue 4 , so that these diseases still represent a major unmet medical need.In the last two decades stem cell therapy has become a promising treatment option for ischemic cardiomyopathy 5 . As a result, the administration of various cell types has been proposed to address this problem but has shown only moderate improvements in cardiac function 6 .Recently, several studies suggest that the beneficial effect of stem cells does not lie in their multiplication, but in their paracrine actions 7 . Based on this insight, current research directions in regenerative cardiology are moving to a cell-less approach, since it is known now that stem cells are able to secrete combinations of biomolecules that modulate the composition of the damaged cardiac environment contributing to functional tissue repair by stimulating the migration, proliferation and survival of endogenous cardiac progenitor cells (eCSCs) 8,9 , as well as attenuating fibrosis and modulating inflammation 10,11 .Among the secreted substances, there are different cytokines, extracellular vesicles and growth factors including insulin-like growth factor-1 (IGF-1), hepatocyte growth factor (HGF), angiopoietin 2 or vascular endothelial 1

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microencapsulated Insulin-Like Growth Factor-1 therapy improves cardiac function and reduces fibrosis in a porcine acute myocardial infarction model

Báez-Díaz

Blanco-Blázquez

Sánchez-Margallo

et al. 2020

Sci Rep

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“…Acute myocardial infarction (AMI) is a leading cause of death worldwide [1, 2]. Recent studies have found that stem cell transplantation is useful for treating myocardial infarction [3].…”

Section: Introductionmentioning

confidence: 99%

Exosomes from MiR-126-Overexpressing Adscs Are Therapeutic in Relieving Acute Myocardial Ischaemic Injury

Luo¹,

Guo²,

Liu³

et al. 2017

Cell Physiol Biochem

229

158

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Background/Aims: Recent studies have indicated that exosomes play an important role in adipose-derived stem cell (ADSC) transplant-mediated ischaemic heart disease therapy. However, the treatment effect is not obvious. The aim of this study is to investigate whether ADSC-derived exosomes enriched with microRNA (miR)-126 have a more protective effect on acute myocardial infarction (AMI). Methods: Exosomes were characterized by transmission electron microscopy, and the exosome particles were further examined using nanoparticle tracking analyses. A rat model of myocardial infarction and in vitro model of hypoxia-induced H9c2 myocardial cell injury were established to study the protective mechanism of exosomes from miR-126-overexpressing ADSCs. Results: The in vitro results showed that exosomes derived from miR-126-overexpressing ADSCs decreased H9c2 myocardial cell injury by reducing inflammation factor expression during hypoxia induction. The miR-126-enriched exosomes also decreased the expression of fibrosis-related proteins of H9c2 cells under hypoxic conditions. Matrigel® and Transwell® assays showed that miR-126-enriched exosomes significantly promoted microvascular generation and migration, respectively. In vivo studies confirmed that exosomes derived from ADSCs significantly decreased the myocardial injury area of infarction, especially after miR-126-enriched exosome treatment. Cardiac fibrosis and inflammatory cytokine expression were also decreased after treatment with miR-126-enriched exosomes. However, blood vessel formation was promoted in the infarction region of AMI rats. Conclusions: The results suggested that the expression of miR-126-enhanced ADSC-derived exosomes prevented myocardial damage by protecting myocardial cells from apoptosis, inflammation, fibrosis, and increased angiogenesis.

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“…As a result, patient risk after an acute MI can be identified by multi-modality imaging approach with echocardiography, ventriculography, and/or Cardiacmagnetic Resonance (CMR) imaging.CMR has the unique ability to assess global and regional LV function post-MI, quantify infarct size with Late Gadolinium Enhancement (LGE), assess the status of the microvasculature by identifying Microvascular Obstruction (MO), and evaluate the area at risk with T2-weighted imaging of myocardial edema. Thus, CMR is uniquely positioned to evaluate the post-infarct patient [11] .…”

Section: Discussionmentioning

confidence: 99%

Role of Cardiac Magnetic Resonance Imaging in the Assessment of Myocardial Viability in Patients with Coronary Artery Disease

Hassanien¹,

Dabees

2018

The Medical Journal of Cairo University

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Background: The principal goal of the assessment of myocardial viability is to identify patients whose symptoms, exercise capacity, and long-term prognosis may improve after revascularization. Contrast enhanced cardiac MRI has developed as a promising imaging modality for the assessment of myocardial viability which provides direct imaging of necrotic tissue with high contrast and high spatial resolution. Aim of the work was to assess role of cardiac MRI as a non-invasive tool in the evaluation of myocardial viability in patients with coronary artery disease. Aim of Study: To assess the role of cardiac MRI as a noninvasive tool in the evaluation of myocardial viability in patients with coronary artery disease. Material and Methods: The study included 25 patients diagnosed as having Coronary Artery Disease (CAD), (age range, 28-68 years ± 11.29). All selected patients were subjected to cardiac MRI examination using 1.5-T MR system for studying myocardial function and viability. Comparison was made between echocardiography and cardiac MRI regarding segmental wall motion using the 17-segment model of the American Heart Association for assessment of myocardial function. Delayed-enhancement MRI was performed to determine myocardial viability and scarring while black blood T2W sequence with fat suppression was done to detect cases with acute infarction. Microvascular occlusion was diagnosed using early Gadolinium enhancement sequence. Results: Good agreement between cardiac MRI and echocardiography regarding segmental wall motion with pvalue of 0.065. Sensitivity and specificity of cardiac MRI for detecting SWMA were 93.6%, and 44.4% respectively. Myocardial viability was evaluated by cardiac MRI with the use of end-diastolic wall thickness, imaging of early and late enhancement after contrast administration. Late gadolinium enhancement allowed assessing state of myocardium and visualizing myocardial scar with its quantification. Two segments showed 1-25% transmural extent of myocardial wall infarction, while 120 segments showed 71-100% extent and 261 segments showed no enhancing scar.

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Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Cited by 34 publications

References 202 publications

Microencapsulated Insulin-Like Growth Factor-1 therapy improves cardiac function and reduces fibrosis in a porcine acute myocardial infarction model

Microencapsulated Insulin-Like Growth Factor-1 therapy improves cardiac function and reduces fibrosis in a porcine acute myocardial infarction model

Exosomes from MiR-126-Overexpressing Adscs Are Therapeutic in Relieving Acute Myocardial Ischaemic Injury

Role of Cardiac Magnetic Resonance Imaging in the Assessment of Myocardial Viability in Patients with Coronary Artery Disease

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