Manganese, a common trace mineral, could improve MRI scans of hearts after a heart attack and guide therapy, according to a new study.
By far the most widely used contrast agent for MRI is gadolinium, which improves the visibility of different organs and tissue types in MRI scans. However, it is taken up equally by cells regardless of their activity, and spreads out in damaged tissue. Furthermore, there are also extremely rare instances of serious kidney damage from its use.
Manganese, besides being less toxic, has a useful property in that it competes with calcium uptake. Calcium handling is highly sensitive to altered heart muscle viability and changes rapidly after damage. Manganese ions enter heart muscle cells through calcium channels, and thus give a useful surrogate for heart tissue viability.
The contrast agent was tested first in vitro with heart muscle cells, and then in mice which had a myocardial infarction (heart attack) induced. The manganese contrast agent was administered with a calcium supplement or administered slowly to negate the effects of manganese interfering with the heart’s calcium channel. Findings were evaluated by examining the infarct size and blood supply at three key intervals: one hour, one day and 14 days after a myocardial infarction was induced. Overall, the manganese contrast agent was superior to gadolinium.
These findings could have major implications for heart attack treatment, if confirmed. They could also be greatly useful in preclinical evaluation of treatments for patients with cardiac ischaemia – where blood supply to the heart muscle is reduced, possibly leading to cardiac arrest.
Furthermore, if manganese-enhanced MRI is performed within the first few hours of a heart attack it could be used to determine the optimal treatment regime for individual patients – helping to regulate changes in the cardiac muscle and thereby further improving survival chances.
“Magnetic resonance imaging (MRI) is increasingly used to diagnose and give information on heart conditions,” said lead researcher Dr Patrizia Camelliti, Senior Lecturer in Cardiovascular Science, University of Surrey. “This research using mice allows us to measure the health status of the heart muscle rapidly after a heart attack and could provide important information for optimizing treatments in patients.”
Source: News-Medical.Net
Journal reference: Jasmin, N.H., et al. (2021) Myocardial Viability Imaging using Manganese‐Enhanced MRI in the First Hours after Myocardial Infarction. Advanced Science. doi.org/10.1002/advs.202003987.