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In vivo assessment of endothelial permeability of coronary lesions with variable degree of stenosis using an albumin-binding MR probe

Research output: Contribution to journalArticlepeer-review

Leif Christopher Engel, Ulf Landmesser, Youssef S. Abdelwahed, Kevin Gigengack, Thomas Wurster, Costantia Manes, Carsten Skurk, Alexander Lauten, Andreas Schuster, Michel Noutsias, Bernd Hamm, Rene M. Botnar, Boris Bigalke, Marcus R. Makowski

Original languageEnglish
Pages (from-to)3049-3055
Number of pages7
JournalINTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Volume37
Issue number10
DOIs
Accepted/In press2021
PublishedOct 2021

Bibliographical note

Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Abstract

MR imaging with an albumin-binding probe enables the visualization of endothelial permeability and damage in the arterial system. The goal of this study was to compare signal enhancement of lesions with different grades of stenosis segments on molecular CMR in combination with the albumin-binding probe gadofosveset. This prospective clinical study included patients with symptoms suggestive of coronary artery disease (CAD). Patients underwent gadofosveset-enhanced cardiovascular magnetic resonance (CMR) imaging and x-ray angiography (QCA) within 24 h. CMR imaging was performed prior to and 24 h following the administration of gadofosveset. Contrast-to-noise ratios (CNRs) between segments with different grades of stenosis were compared. Overall, n = 203 segments of 26 patients were included. Lesions with more than > 70% stenosis demonstrated significantly higher CNRs compared to lesions < 70% (7.6 ± 8.3 vs. 2.5 ± 4.9; p < 0.001). Post-stenotic segments of lesions > 70% stenosis showed significant higher signal enhancement compared to segments located upstream of these lesions (7.3 ± 8.8 vs. 2.8 ± 2.2; p = 0.02). No difference in signal enhancement between segments proximal and distal of lesions with stenosis greater than 50% was measured (3.3 ± 2.8 vs. 2.4 ± 2.7; p = 0.18). ROC analysis for the detection of lesions ≥ 70% revealed an area under the curve of 0.774 (95% CI 0.681–0.866). This study suggests that relevant coronary stenosis and their down-stream segments are associated with increased signal enhancement on Gadofosveset-enhanced CMR, suggesting a higher endothelial permeability in these lesions. An albumin-binding MR probe could represent a novel in vivo biomarker for the identification and characterization of these vulnerable coronary segments.

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