Detection of High-Risk Plaque with tropoelastin-specific and multicontrast coronary MRI (renewal)

Dysfunctional extracellular matrix (ECM) remodelling, intraplaque haemorrhage (IPH), and thrombus are promising imaging biomarkers for the identification of high-risk patients in addition to the established coronary calcium score.

Here, we propose to build on discoveries made during the last funding period of our programme grant (RG/12/1/29262) to develop a novel comprehensive multi-contrast and molecular imaging protocol, using a novel tropoelastin-specific MR contrast agent (TESMA), for coronary plaque imaging.

Specifically, we will investigate 1) the merits of Gd-TESMA to identify active dysfunctional elastin turnover, as a promising biomarker of atheroscleroticdisease activity and high-risk plaque, in murine and porcine preclinical models of stable and unstable plaque andfor the first time translate these findings using 68Ga-TESMA in patients with stable and unstable coronary artery disease.

To enable comprehensive non-invasive coronary plaque imaging, we will 2) devise and validate a novel coronary plaque MR imaging protocol for contrast-free detection of plaque burden and high-risk plaque features by providing images of coronary stenosis, calcification, intraplaque haemorrhage and intraluminal thrombus in a single 3D free-breathing examination in less than 10 minutes.