To non-invasively image myocardial accumulation of ultrasmall superparamagnetic particles of iron oxide (USPIOs) by an increase in R2\* values (compared to controls) within the myocardium of patients with: i. cardiac transplantation ii. acute myocarditis iii. suspected cardiac sarcoidosis
Ferumoxytol is a 'smart' magnetic resonance contrast agent consisting of ultrasmall superparamagnetic particles of iron oxide (USPIOs) that are taken up by macrophages. Concentration of USPIOs within macrophages changes the tissue relaxation properties and this can be detected by magnetic resonance imaging using R2\* maps. In a recent early proof-of-concept study, we demonstrated that macrophages could be detected with USPIOs in the penumbra and infarct zone of the myocardium in patients with a recent myocardial infarction. The investigators therefore wish to establish whether USPIOs can be used to identify cellular inflammation within the myocardium in three distinct clinical conditions that currently lack a non-invasive diagnostic imaging test: cardiac allograft rejection, viral myocarditis and cardiac sarcoidosis. If successful, this would not only provide a useful diagnostic test but would also be a method of monitoring disease progression or response to therapy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
58
Infusion following between paired MRI scans
Royal Infirmary of Edinburgh
Edinburgh, United Kingdom
Golden Jubilee National Hospital
Glasgow, United Kingdom
Royal Brompton Hospital
London, United Kingdom
Assessment of Myocardial Cellular Inflammation.
Assessment of Myocardial Cellular Inflammation through the increase in R2\* value on post USPIO imaging versus baseline imaging.
Time frame: 1 year
Correlation of R2* values with circulating inflammatory markers
Comparison of circulating inflammatory markers in peripheral blood with myocardial inflammation (seen on cardiac R2\* maps) .
Time frame: 1 year
Does clinical condition correlate with inflammation seen on R2* maps. (assessed by reduction in R2* values)
Does treatment or recovery from these inflammatory myocardial conditions reduce or halt uptake of USPIOs as assessed by reduction in R2\* values.
Time frame: 1 year
Do higher R2* correlate with poorer outcome? (assessed by deterioration in ejection fraction or increase in late gadolinium enhancement)
Do patients with higher R2\* values have worse outcomes assessed by deterioration in ejection fraction or increase in late gadolinium enhancement.
Time frame: 1 year
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