Manganese dipyridoxyl-diphosphate (MnDPDP) as a viability marker in patients with myocardial infarction

J Magn Reson Imaging. 2007 Sep;26(3):720-7. doi: 10.1002/jmri.21065.

Abstract

Purpose: To evaluate contrast accumulation in left ventricular (LV) myocardium after manganese dipyridoxyl-diphosphate (MnDPDP) administration in patients with recent first time myocardial infarction.

Materials and methods: MnDPDP (5 micromol/kg) was administered to 10 patients with recent myocardial infarction (three to 12 weeks). One slice of interest (SOI) likely to traverse the infarction was chosen, and sectorial pre- and postcontrast longitudinal relaxivity rates (R(1)) and signal changes during infusion were estimated with a fast gradient echo sequence. LV volume and wall thickening were measured in short-axis cine recordings. Infarct localization from R(1) and wall thickening data were compared by vector analyses.

Results: Reduced wall thickening was associated with reduced precontrast R(1) and reduced contrast enhancement. Both remote and infarcted regions showed rapid initial contrast accumulation. In remote regions, this was followed by a continuing slow increase. Mean precontrast R(1) was 0.87 +/- 0.06 second(-1) in infarcted regions and 0.96 +/- 0.03 second(-1) in remote regions (P < 0.001). Mean R(1) change over one hour was 0.24 +/- 0.07 second(-1) in infarcted regions and 0.38 +/- 0.03 second(-1) in remote regions (P < 0.0001).

Conclusion: Remote regions showed larger increases in R(1) than infarcted regions. This is most likely due to selective and slow Mn accumulation in viable myocytes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / chemistry
  • Contrast Media / pharmacology*
  • Coronary Vessels / pathology
  • Echocardiography / methods*
  • Edetic Acid / analogs & derivatives*
  • Edetic Acid / pharmacology
  • Female
  • Heart Ventricles / pathology*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / pathology*
  • Pyridoxal Phosphate / analogs & derivatives*
  • Pyridoxal Phosphate / pharmacology
  • Treatment Outcome

Substances

  • Biomarkers
  • Contrast Media
  • Pyridoxal Phosphate
  • Edetic Acid
  • N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid