Frederick Epstein

Coronary microvascular disease (CMD) is an important cause of myocardial ischemia, a central mechanism underlying heart failure with preserved ejection fraction, and an important risk factor for major adverse cardiac events and mortality.  This presentation reviews pharmacological methods to modulate the coronary microvessels and their use in MR imaging to detect and quantify CMD.  Specific methods covered include adenosine first-pass gadolinium-enhanced MRI, adenosine T1 mapping, arterial spin labeling, and LNAME T1 mapping.  Studies applying these methods in obese and diabetic patients are reviewed, as are studies in animal models of CMD that investigate biological disease mechanisms and novel therapies.   

Sebastian Temme, Patricia Kleimann , Pascal Bouvain, Arthur Zielinski, Jeny Koshy, Mina Yakoub, Florian Bönner , Christoph Jacoby, Francesca Baldelli-Bombelli , Karlheinz Peter, Xiaowei Wang, Jürgen Schrader, Johannes Stegbauer, Ulrich Flögel

Thromboinflammation is characterized by a close interaction of immune cells, platelets and components of the coagulation cascade. This impairs the systemic spread of pathogens, but can also foster the development and progression of cardiovascular diseases like deep vein thrombosis, atherosclerosis or myocardial infarction. Non-invasive visualization of thromboinflammation is challenging, because it requires the simultaneous imaging of thrombosis and immune cells. In this context, ¹⁹F MRI offers unique opportunities because of the large chemical shift range of the ¹⁹F-atoms and the availability of perfluorocarbons with individual spectral signatures that enables the visualization of thromboinflammatory processes by multispectral ¹⁹F MRI.

Ulrich Floegel

The present talk demonstrates that both human and murine neutrophils can be specifically targeted to track their dynamic trafficking by non-invasive MRI in vivo. In clinical translation, this approach will allow not only to identify hidden origins of bacterial or sterile inflammation in patients but also to unravel cardiovascular disease states that are on the verge of severe aggravation due to enhanced neutrophil infiltration or activation.

Rene Botnar

Coronary artery disease remains the major cause of death in many western and developing nations. Magnetic resonance imaging offers the unique opportunity to provide comprehensive evaluation of CAD as it allows to interrogate coronary luminal narrowing and detect and characterise coronary plaque both with/without contrast agents. In this presentation, I will discuss the latest developments in coronary angiography and plaque imaging and review novel endogenous/exogenous contrasts for plaque characterisation. Special focus will be given to clinical validation studies that have compared novel coronary imaging sequences with reference standards such as X-ray, computed tomography, intravascular ultrasound and optical coherence tomography.

Gustav Strijkers

Inflammation is a hallmark of multiple diseases and inflammatory factors can affect different systems in your body. Inflammatory cardiovascular diseases, including endocarditis and sarcoidosis, present a diagnostic challenge, and the inflammatory response after myocardial infarction stimulates adverse myocardial remodeling. Hence, there is a great need for the direct non-invasive visualization and quantification of myocardial inflammation to improve clinical diagnosis and decision making.In this educational presentation I will discuss the need for non-invasive imaging of inflammation and the pros and cons of several established and emerging MRI techniques for imaging of myocardial inflammation, including the use of iron-oxides and hyperpolarized substrates.