Elsevier

JACC: Cardiovascular Imaging

Volume 6, Issue 12, December 2013, Pages 1327-1341
JACC: Cardiovascular Imaging

State-of-the-Art Paper
The Advancing Clinical Impact of Molecular Imaging in CVD

https://doi.org/10.1016/j.jcmg.2013.09.014Get rights and content
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Molecular imaging seeks to unravel critical molecular and cellular events in living subjects by providing complementary biological information to current structural clinical imaging modalities. In recent years, molecular imaging efforts have marched forward into the clinical cardiovascular arena, and are now actively illuminating new biology in a broad range of conditions, including atherosclerosis, myocardial infarction, thrombosis, vasculitis, aneurysm, cardiomyopathy, and valvular disease. Development of novel molecular imaging reporters is occurring for many clinical cardiovascular imaging modalities (positron emission tomography, single-photon emission computed tomography, magnetic resonance imaging), as well as in translational platforms such as intravascular fluorescence imaging. The ability to image, track, and quantify molecular biomarkers in organs not routinely amenable to biopsy (e.g., the heart and vasculature) open new clinical opportunities to tailor therapeutics based on a cardiovascular disease molecular profile. In addition, molecular imaging is playing an increasing role in atherosclerosis drug development in phase II clinical trials. Here, we present state-of-the-art clinical cardiovascular molecular imaging strategies, and explore promising translational approaches positioned for clinical testing in the near term.

Key Words

aneurysm
atherosclerosis
heart failure
molecular imaging
myocardial infarction
thrombosis
valvular disease
vascular injury

Abbreviations and Acronyms

158Gd-ESMA
gadolinium-labeled elastin-specific magnetic resonance contrast agent
AS
aortic stenosis
AT1R
angiotensin II type 1 receptor
CAC
coronary artery calcium
CEA
carotid endarterectomy
CMR
cardiac magnetic resonance
CT
computed tomography
DVT
deep vein thrombosis
FDA
Food and Drug Administration
FDG
18F-fluorodeoxyglucose
hsCRP
high-sensitivity C-reactive protein
ICG
indocyanine green
LDL
low-density lipoprotein
LV
left ventricle/ventricular
MI
myocardial infarction
MMP
matrix metalloproteinase
MRI
magnetic resonance imaging
NaF
18F-sodium fluoride
NIRF
near-infrared fluorescence
OFDI
optical frequency domain imaging
OTW
over-the-wire
PC
perfusion catheter
PET
positron emission tomography
RAAS
renin-angiotensin-aldosterone system
SUV
standardized uptake value
TBR
target-to-background ratio
USPIO
ultrasmall superparamagnetic particles of iron oxide

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Funded by a National Institutes of Health grant R01 HL108229, American Heart Association Scientist Development Grant #0830352N and Grant-in-Aid #13GRNT1760040, and NIH T32 HL007374 support for Dr. Osborn. Dr. Jaffer has received research funding from Abbott Vascular, Merck & Co., and Kowa Company, Ltd.