PROTON NMR STRATEGIES TO ASSESS ISCHEMIC HEART DISEASE

描述（改编自申请人摘要）：在心肌梗死后， 缺血性事件发生后，受影响的部分发生了许多变化， 心肌 缺血区域的中心可能受到不可逆的损伤， 导致细胞死亡和坏死。 围绕着这个中央梗塞区 是心肌受到缺血影响的危险区域 但是，通过适当的干预，仍然有恢复的潜力。 关于可行区域范围的信息对于以下方面至关重要： 诊断、预后和适当干预的计划。 的 申请人提出将不可逆损伤（IR）、缺血性 正常组织中受损伤但存活（IV）和冬眠（H）心肌 使用核磁共振，非受累且无造影剂 (NMR)成像和光谱技术。 这些技术包括： 功能电影成像，以确定收缩特性的 心肌;磁化传递对比成像识别红外组织; T2加权快速自旋回波成像，以识别IR和IV组织;以及 水抑制脂质成像和1H光谱成像以识别IV。 冬眠心肌通过脂质成像结合 异常收缩 近期有过梗死或有慢性 稳定缺血性疾病或患有缺血性心肌病， IR、IV和H度。通过研究这些病人， 适当时，申请人建议确认这些 不同的组织 此外，MTC效应在实验室中很少被理解。 心 使用缺血的犬模型，申请人建议遵循 MTC效应的发展，并将其与离体进行比较。 图像 和组织学。 通过使用这些方法以及高质量的 可以通过质子核磁共振生成的功能图像 心脏成像，缺血性损伤的类型和程度应 评估。 一旦成功完成，这些信息就可以 临床上可能会对心脏病学的未来产生影响。

DESCRIPTION (Adapted from Applicant's Abstract): Following a myocardial ischemic event, a number of changes take place in the affected part of the myocardium. The center of the ischemic region may be irreversibly damaged, leading to cell death and necrosis. Surrounding this central infarct zone is a region at risk, where the myocardium has been affected by the ischemic event but, with proper intervention, still has the potential for recovery. Information about the extent of the viable region is essential for diagnosis, prognosis, and the planning of appropriate intervention. The applicants proposed to differentiate irreversibly damaged (IR), ischemically insulted but viable (IV), and hibernating (H) myocardium from normal tissue non-involved and without contrast agents using nuclear magnetic resonance (NMR) imaging and spectroscopic techniques. These techniques include: function cine imaging to identify the contractile properties of the myocardium; magnetization transfer contrast imaging to identify IR tissue; T2-weighted turbo spin echo imaging to identify IR and IV tissue; and water-suppressed lipid imaging and 1H spectroscopic imaging to identify IV. Hibernating myocardium is identified by lipid imaging in conjunction with abnormal contraction. Patients who have had recent infarcts or have chronic stable ischemic disease or have ischemic cardiomyopathies have varying degrees of IR, IV, and H. By studying these patients and following up where appropriate, the applicants proposed to confirm the identification of these different tissues. In addition, the MTC effect is little understood in the heart. Using a canine model of ischemia, the applicants proposed to follow the development of the MTC effect and compare it to both ex vivo. images and histology. By using these approaches together with the high quality functional images that can be generated by proton nuclear magnetic resonance cardiac imaging, the type and extent of ischemic damage should be assessable. Once accomplished successfully, such information derived clinically could have an impact on the future of the practice of cardiology.