Imaging the myocardium at risk with (99m)Tc-lactadherin administered after reperfusion in a porcine model

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Phosphatidylserine is translocated from the inner to the outer leaflet of the plasma membrane in the early stages of apoptosis and necrosis and in reversibly injured cells. In rabbit hearts, ischemia followed by reperfusion results in exposure of phosphatidylserine on myocytes unaffected by apoptosis or necrosis. Lactadherin was recently introduced as a highly sensitive phosphatidylserine ligand. We hypothesized that ischemic myocardial cell damage can be identified by radio-labeled lactadherin and that the ischemic area at risk (AAR) can be visualized retrospectively after reperfusion.

Methods
Left anterior descending coronary artery in pigs was occluded for 20minutes, 45minutes or 45minutes preceded by ischemic preconditioning. In all three groups, 99mTc-lactadherin was injected intravenously 30minutes after reperfusion. The AAR was demarcated by Evans blue and the infarct size by 2,3,5,-triphenyltetrazodium chloride staining.

Results
The regional myocardial uptake of 99mTc-lactadherin closely correlated with the AAR (r=.83, P = .001). The area of 99mTc–lactadherin uptake was unaltered by a shorter duration of ischemia and ischemic preconditioning (P=.23) despite significantly different infarct development (P=.001).

Conclusion
The results suggest that 99mTc–lactadherin can be used as a sensitive marker for AAR imaging when injected 30minutes after reperfusion following acute ischemia.
Original languageEnglish
JournalNuclear Medicine and Biology
Volume41
Issue1
Pages (from-to)114-119
Number of pages6
ISSN0969-8051
DOIs
Publication statusPublished - Jan 2014

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