Manganese Enhanced Magnetic Resonance Imaging (MRI) in Ischaemic and Takotsubo Cardiomyopathy.

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Scanning the heart using magnetic resonance imaging (MRI) enables detailed assessment of its structure and function. MRI can give more detailed information about the heart by using a contrast 'dye' that is injected into a vein during the scan. This can highlight abnormal areas within the heart. Current contrast dyes help identify scarring within the heart. Recent studies using a new contrast dye containing manganese has been used in patients with diseased heart arteries (ischemic heart disease) and cardiac conditions affecting the heart muscle (cardiomyopathy). This has shown abnormal uptake of the dye in patients with ischemic heart disease and various cardiomyopathies. It has also shown advantages over traditional contrast; firstly, it can measure the amount of scar more accurately and secondly it can quantify scar.Heart failure is a condition in which the heart muscle is weakened and pumping function is reduced. It is caused by various conditions including different heart muscle diseases and those affecting the heart arteries. Heart failure is a global pandemic affecting at least 26 million people worldwide. Despite the significant advances in therapies and prevention, mortality and morbidity are still high and quality of life poor. Heart failure imposes both direct and indirect costs to healthcare systems and has a significant impact on global health. We plan to further test this manganese containing dye as we believe it will provide better understanding into reversible cardiac conditions. Our study will be conducted in the Queen's Medical Research Institute (QMRI) at the Royal Infirmary Edinburgh led by Dr Trisha Singh. This is a clinical study which will involve using this new contrast agent to scan three patient groups; i) heart attacks by a blocked heart artery (ii) heart disease caused mismatch in blood supply and demand (angina) (iii) heart disease secondary to a stress response (takotsubo). We will scan healthy volunteers for comparison. We believe this new agent has potential to better measure disease in the heart, improve our ability to establish the cause of heart disease and help monitor the disease over time as well as guide future treatment for individual patients. This has the potential to change clinical practice and make an impact on patient care.