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Targeted imaging of myocardial damage

Nature Clinical Practice Cardiovascular Medicine volume 5, pages S63–S70 (2008)Cite this article

Abstract

Molecular imaging agents can be targeted to a specific receptor or protein on the cardiomyocyte surface, or to enzymes released into the interstitial space, such as cathepsins, matrix metalloproteinases and myeloperoxidase. Molecular imaging of the myocardium, however, requires the imaging agent to be small, sensitive (nanomolar levels or better), and able to gain access to the interstitial space. Several novel agents that fulfill these criteria have been used for targeted molecular imaging applications in the myocardium. Magnetic resonance, fluorescence, and single-photon emission CT have been used to image the molecular signals generated by these agents. The use of targeted imaging agents in the myocardium has the potential to provide valuable insights into the pathophysiology of myocardial injury and to facilitate the development of novel therapeutic strategies.

Key Points

  • Targeted molecular imaging in the myocardium requires the imaging agent to be small (<50 nm), sensitive (nanomolar to picomolar levels), and able to gain access to the interstitial space

  • MRI has been successfully used to image necrosis, apoptosis, macrophage infiltration, and myeloperoxidase activity in the myocardium

  • SPECT imaging has been used to visualize necrosis, apoptosis, angiogenesis, and matrix metalloproteinases in injured myocardium

  • Fluorescence techniques possess many desirable attributes for molecular imaging of the myocardium but, at present, are limited to invasive approaches in humans

  • Several novel imaging agents, suited to targeted molecular imaging in the myocardium, have already completed phase III clinical trials

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Figure 1: SPECT imaging of molecular targets in the myocardium.
Figure 2: Targeted molecular MRI in the myocardium.
Figure 3: Noninvasive MRI and fluorescence tomography of the mouse heart.
Figure 4: Invasive and noninvasive fluorescence imaging approaches.

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Acknowledgements

DE Sosnovik and R Weissleder were funded by NIH grants. R Weissleder also received funding from the Donald W Reynolds Cardiovascular Clinical Research Center, Harvard Medical School, Boston, MA, USA.

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Authors and Affiliations

  1. DE Sosnovik is the Director and M Nahrendorf the Co-Director of Cardiac Imaging at the Center for Molecular Imaging Research, and R Weissleder is the Director of the Center for Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,

    David E Sosnovik, Matthias Nahrendorf & Ralph Weissleder

Authors
  1. David E Sosnovik
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  2. Matthias Nahrendorf
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  3. Ralph Weissleder
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Corresponding author

Correspondence to David E Sosnovik.

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Competing interests

Ralph Weissleder is a consultant for and a stockholder in VisEn Medical, Woburn, MA, USA. The other authors declared no competing interests.

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Sosnovik, D., Nahrendorf, M. & Weissleder, R. Targeted imaging of myocardial damage. Nat Rev Cardiol 5 (Suppl 2), S63–S70 (2008). https://doi.org/10.1038/ncpcardio1115

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