Noninvasive Characterization of Myocardial Molecular Interventions by Integrated Positron Emission Tomography and Computed Tomography

Bettina Wagner, Martina Anton, Stephan G. Nekolla, Sybille Reder, Julia Henke, Stefan Seidl, Renate Hegenloh, Masao Miyagawa, Roland Haubner, Markus Schwaiger, Frank M. Bengel

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We sought to investigate the usefulness of integrated positron emission tomography (PET) and computed tomography (CT) for in vivo characterization of an angiogenesis-directed molecular intervention. Background: Controversies about the effectiveness of molecular therapies for cardiovascular disease have prompted the need for more powerful noninvasive imaging techniques. Methods: In a model of regional adenoviral transfer of the VEGF121 gene to myocardium of healthy pigs, PET-CT using multiple molecular-directed radiotracers was employed. Results: Two days after gene transfer, successful transgene expression was noninvasively confirmed by a reporter probe targeting co-expressed HSV1-sr39tk reporter gene. The CT-derived ventricular function and morphology remained unaltered (left ventricular ejection fraction 57 ± 5% in adenovirus-injected animals vs. 53 ± 5% in controls; p = 0.36). Increased regional perfusion was identified in areas overexpressing VEGF (myocardial blood flow during adenosine-induced vasodilation 1.47 ± 0.49 vs. 1.14 ± 0.27 ml/g/min in remote areas; p = 0.01), corroborating in vivo effects on microvascular tone and permeability. Finally, regional angiogenesis-associated αvβ3 integrin expression was not enhanced, suggesting little contribution to the perfusion increase. Fusion of CT morphology and tracer-derived molecular signals allowed for accurate regional localization of biologic signals. Findings were validated by control vectors, sham-operated animals, and ex vivo tissue analysis. Conclusions: Integrated PET-CT has the potential to dissect cardiovascular biologic mechanisms from gene expression to physiologic function and morphology. The VEGF overexpression in healthy myocardium increases myocardial perfusion without significant up-regulation of αvβ3 integrin adhesion molecules early after the intervention.

Original languageEnglish (US)
Pages (from-to)2107-2115
Number of pages9
JournalJournal of the American College of Cardiology
Volume48
Issue number10
DOIs
StatePublished - Nov 21 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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