AIMS: The purpose of this clinical trial was to investigate whether cardiovascular magnetic resonance imaging (CMR) using ferumoxytol (Feraheme™, FH), an ultrasmall superparamagnetic iron oxide nanoparticle (USPIO), allows more detailed characterization of infarct pathology compared with conventional gadolinium-based necrosis/fibrosis imaging in patients with acute myocardial infarction. METHODS AND RESULTS: Fourteen patients who had experienced an acute ST-elevation myocardial infarction were included in this study. Following coronary angiography, a first baseline study (pre-FH) was performed followed by subsequent CMR studies (post-FH) 48 h after intravenous ferumoxytol administration. The CMR studies comprised cine-CMR, T(2)-weighted short tau inversion recovery spin echo imaging, T(2)-mapping, and T(1)-weighted late gadolinium enhancement (LGE) imaging. The median extent of short-axis in-plane LGE was 30% [inter-quartile range (IQR) 26-40%]. The median in-plane extent of T(2)-weighted 'hypoenhancement' in the region of myocardial infarction, which was not present prior to ferumoxytol administration in any patient, was 19% (IQR 14-22%; P < 0.001 compared with the extent of LGE). The median in-plane extent of areas showing signal void in T(2)-mapping images post-FH in the region of myocardial infarction was 16% (IQR 12-18%; P < 0.001 compared with the extent of LGE; P = 0.34 compared with the extent of T(2)-weighted hypoenhancement). A substantial drop in absolute T(2)-values was observed not only in the infarct core and peri-infarct zone, but also in the remote 'healthy' myocardium, although there was only a minor change in the skeletal muscle. Substantial ferumoxytol uptake was detected only in cultured macrophages, but not in peripheral blood monocytes from study patients. CONCLUSION: We could demonstrate in humans that USPIO-based contrast agents enable a more detailed characterization of myocardial infarct pathology mainly by detecting infiltrating macrophages. Considering the multi-functionality of USPIO-based particles and their superior safety profile compared with gadolinium-based compounds, these observations open up new vistas for the clinical application of USPIO.
AIMS: The purpose of this clinical trial was to investigate whether cardiovascular magnetic resonance imaging (CMR) using ferumoxytol (Feraheme™, FH), an ultrasmall superparamagnetic iron oxide nanoparticle (USPIO), allows more detailed characterization of infarct pathology compared with conventional gadolinium-based necrosis/fibrosis imaging in patients with acute myocardial infarction. METHODS AND RESULTS: Fourteen patients who had experienced an acute ST-elevation myocardial infarction were included in this study. Following coronary angiography, a first baseline study (pre-FH) was performed followed by subsequent CMR studies (post-FH) 48 h after intravenous ferumoxytol administration. The CMR studies comprised cine-CMR, T(2)-weighted short tau inversion recovery spin echo imaging, T(2)-mapping, and T(1)-weighted late gadolinium enhancement (LGE) imaging. The median extent of short-axis in-plane LGE was 30% [inter-quartile range (IQR) 26-40%]. The median in-plane extent of T(2)-weighted 'hypoenhancement' in the region of myocardial infarction, which was not present prior to ferumoxytol administration in any patient, was 19% (IQR 14-22%; P < 0.001 compared with the extent of LGE). The median in-plane extent of areas showing signal void in T(2)-mapping images post-FH in the region of myocardial infarction was 16% (IQR 12-18%; P < 0.001 compared with the extent of LGE; P = 0.34 compared with the extent of T(2)-weighted hypoenhancement). A substantial drop in absolute T(2)-values was observed not only in the infarct core and peri-infarct zone, but also in the remote 'healthy' myocardium, although there was only a minor change in the skeletal muscle. Substantial ferumoxytol uptake was detected only in cultured macrophages, but not in peripheral blood monocytes from study patients. CONCLUSION: We could demonstrate in humans that USPIO-based contrast agents enable a more detailed characterization of myocardial infarct pathology mainly by detecting infiltrating macrophages. Considering the multi-functionality of USPIO-based particles and their superior safety profile compared with gadolinium-based compounds, these observations open up new vistas for the clinical application of USPIO.
Authors: Florian Leuschner; Gabriel Courties; Partha Dutta; Luke J Mortensen; Rostic Gorbatov; Brena Sena; Tatiana I Novobrantseva; Anna Borodovsky; Kevin Fitzgerald; Victor Koteliansky; Yoshiko Iwamoto; Marina Bohlender; Soeren Meyer; Felix Lasitschka; Benjamin Meder; Hugo A Katus; Charles Lin; Peter Libby; Filip K Swirski; Daniel G Anderson; Ralph Weissleder; Matthias Nahrendorf Journal: Eur Heart J Date: 2014-06-20 Impact factor: 29.983
Authors: Iwona Cicha; Cédric Chauvierre; Isabelle Texier; Claudia Cabella; Josbert M Metselaar; János Szebeni; László Dézsi; Christoph Alexiou; François Rouzet; Gert Storm; Erik Stroes; Donald Bruce; Neil MacRitchie; Pasquale Maffia; Didier Letourneur Journal: Cardiovasc Res Date: 2018-11-01 Impact factor: 10.787
Authors: Gerda B Toth; Csanad G Varallyay; Andrea Horvath; Mustafa R Bashir; Peter L Choyke; Heike E Daldrup-Link; Edit Dosa; John Paul Finn; Seymur Gahramanov; Mukesh Harisinghani; Iain Macdougall; Alexander Neuwelt; Shreyas S Vasanawala; Prakash Ambady; Ramon Barajas; Justin S Cetas; Jeremy Ciporen; Thomas J DeLoughery; Nancy D Doolittle; Rongwei Fu; John Grinstead; Alexander R Guimaraes; Bronwyn E Hamilton; Xin Li; Heather L McConnell; Leslie L Muldoon; Gary Nesbit; Joao P Netto; David Petterson; William D Rooney; Daniel Schwartz; Laszlo Szidonya; Edward A Neuwelt Journal: Kidney Int Date: 2017-04-20 Impact factor: 10.612
Authors: Hushan Yuan; Moses Q Wilks; Marc D Normandin; Georges El Fakhri; Charalambos Kaittanis; Lee Josephson Journal: Nat Protoc Date: 2018-01-25 Impact factor: 13.491