PMID- 28986407
OWN - NLM
STAT- MEDLINE
DCOM- 20181114
LR  - 20240207
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 104
IP  - 4
DP  - 2018 Feb
TI  - Ferumoxytol-enhanced magnetic resonance imaging in acute myocarditis.
PG  - 300-305
LID - 10.1136/heartjnl-2017-311688 [doi]
AB  - OBJECTIVES: Ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced 
      MRI can detect tissue-resident macrophage activity and identify cellular 
      inflammation within tissues. We hypothesised that USPIO-enhanced MRI would 
      provide a non-invasive imaging technique that would improve the diagnosis and 
      management of patients with acute myocarditis. METHODS: Ten volunteers and 14 
      patients with suspected acute myocarditis underwent T2, T2* and late gadolinium 
      enhancement (LGE) 3T MRI, with further T2* imaging at 24 hours after USPIO 
      (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months. Myocardial oedema and 
      USPIO enhancement were determined within areas of LGE as well as throughout the 
      myocardium. RESULTS: Myocarditis was confirmed in nine of the 14 suspected cases 
      of myocarditis. There was greater myocardial oedema in regions of LGE in patients 
      with myocarditis when compared with healthy volunteer myocardium (T2 value, 
      57.1+/-5.3 vs 46.7+/-1.6 ms, p<0.0001). There was no demonstrable difference in USPIO 
      enhancement between patients and volunteers even within regions displaying LGE 
      (change in R2*, 35.0+/-15.0 vs 37.2+/-9.6 s(-1), p>0.05). Imaging after 3 months in 
      patients with myocarditis revealed a reduction in volume of LGE, a reduction in 
      oedema measures within regions displaying LGE and improvement in ejection 
      fraction (mean -19.7 mL, 95% CI (-0.5 to -40.0)), -5.8 ms (-0.9 to -10.7) and +6% 
      (0.5% to 11.5%), respectively, p<0.05 for all). CONCLUSION: In patients with 
      acute myocarditis, USPIO-enhanced MRI does not provide additional clinically 
      relevant information to LGE and T2 mapping MRI. This suggests that 
      tissue-resident macrophages do not provide a substantial contribution to the 
      myocardial inflammation in this condition.Clinical trial registration 
      NCT02319278; Results.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Stirrat, Colin G
AU  - Stirrat CG
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - Alam, Shirjel R
AU  - Alam SR
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - MacGillivray, Thomas J
AU  - MacGillivray TJ
AD  - Clinical Research Facility, University of Edinburgh, Edinburgh, UK.
AD  - Edinburgh Imaging QMRI Facility, University of Edinburgh, Edinburgh, UK.
FAU - Gray, Calum D
AU  - Gray CD
AD  - Clinical Research Facility, University of Edinburgh, Edinburgh, UK.
AD  - Edinburgh Imaging QMRI Facility, University of Edinburgh, Edinburgh, UK.
FAU - Dweck, Marc R
AU  - Dweck MR
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - Dibb, Kevin
AU  - Dibb K
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - Spath, Nick
AU  - Spath N
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - Payne, John R
AU  - Payne JR
AD  - Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK.
FAU - Prasad, Sanjay K
AU  - Prasad SK
AD  - Department of Cardiology, Royal Brompton Hospital, London, UK.
FAU - Gardner, Roy S
AU  - Gardner RS
AD  - Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK.
FAU - Mirsadraee, Saeed
AU  - Mirsadraee S
AD  - Department of Radiology, Royal Brompton Hospital, London, UK.
FAU - Henriksen, Peter A
AU  - Henriksen PA
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
FAU - Semple, Scott Ik
AU  - Semple SI
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
AD  - Edinburgh Imaging QMRI Facility, University of Edinburgh, Edinburgh, UK.
FAU - Newby, David E
AU  - Newby DE
AD  - British Heart Foundation/University Centre for Cardiovascular Science, University 
      of Edinburgh, Edinburgh, UK.
AD  - Edinburgh Imaging QMRI Facility, University of Edinburgh, Edinburgh, UK.
LA  - eng
SI  - ClinicalTrials.gov/NCT02319278
GR  - FS/17/19/32641/BHF_/British Heart Foundation/United Kingdom
GR  - FS/14/78/31020/BHF_/British Heart Foundation/United Kingdom
GR  - ETM/266/CSO_/Chief Scientist Office/United Kingdom
GR  - G0701127/MRC_/Medical Research Council/United Kingdom
GR  - WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171006
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Contrast Media)
RN  - 0 (Dextrans)
RN  - 0 (Magnetite Nanoparticles)
RN  - 0 (ferumoxtran-10)
SB  - IM
CIN - Heart. 2018 Feb;104(4):278-279. PMID: 28780574
MH  - Acute Disease
MH  - Adult
MH  - Contrast Media/pharmacology
MH  - Dextrans/*pharmacology
MH  - Female
MH  - Humans
MH  - Image Enhancement/methods
MH  - Image Interpretation, Computer-Assisted/methods
MH  - Inflammation/diagnostic imaging
MH  - Macrophage Activation/immunology
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Magnetite Nanoparticles
MH  - Male
MH  - Middle Aged
MH  - *Myocarditis/diagnostic imaging/immunology/pathology
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
PMC - PMC5861394
OTO - NOTNLM
OT  - MRI
OT  - USPIO.
OT  - cardiac
OT  - inflammation
OT  - myocarditis
COIS- Competing interests: None declared.
EDAT- 2017/10/08 06:00
MHDA- 2018/11/15 06:00
PMCR- 2018/03/21
CRDT- 2017/10/08 06:00
PHST- 2017/04/13 00:00 [received]
PHST- 2017/05/24 00:00 [revised]
PHST- 2017/06/12 00:00 [accepted]
PHST- 2017/10/08 06:00 [pubmed]
PHST- 2018/11/15 06:00 [medline]
PHST- 2017/10/08 06:00 [entrez]
PHST- 2018/03/21 00:00 [pmc-release]
AID - heartjnl-2017-311688 [pii]
AID - 10.1136/heartjnl-2017-311688 [doi]
PST - ppublish
SO  - Heart. 2018 Feb;104(4):300-305. doi: 10.1136/heartjnl-2017-311688. Epub 2017 Oct 
      6.