Sophia Xinyuan Cui1 and Frederick H. Epstein1,2
1Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, 2Radiology, University of Virginia, Charlottesville, VA, United States
Synopsis
Endothelial nitric oxide synthase (eNOS)-mediated
production of NO is an important system regulating the microvasculature,
controlling both vessel diameter and permeability. We hypothesized that T1 mapping of the heart
during NOS inhibition could detect increased water content resulting from increased
microvascular permeability, providing a novel means to noninvasively probe eNOS
regulation of the coronary microvasculature.
T1-mapping in mice after intravenous NOS inhibition detected an increase
in myocardial T1 of 113±15 ms compared to baseline (p<0.05). These methods are likely probing eNOS
regulation of coronary microvascular permeability, which may represent a novel
means of assessing the health of the coronary endothelium. Introduction
The
vascular endothelium is a monolayer of cells that lines the inner surface of
blood vessels and, through production of various bioactive factors, closely
regulates vessel tone, blood flow, and microvascular permeability. Endothelial
nitric oxide synthase (eNOS)-mediated production of NO is one of the most
important systems regulating the microvasculature, controlling both vessel
diameter and permeability. With regard to the latter, in healthy
microvasculature eNOS actively maintains endothelial barrier integrity and
inhibition of NOS rapidly increases permeability [1]. We hypothesized that native (non-contrast-enhanced)
T1 mapping of the heart during NOS inhibition would detect elevated myocardial
T1 corresponding to increased interstitial water content resulting from
increased microvascular permeability, providing a novel means to noninvasively
probe eNOS regulation of the coronary microvasculature. The ability to noninvasively
image eNOS regulation of coronary microvascular permeability may potentially be
useful as a means of detecting coronary endothelial dysfunction, as this finely
controlled system may be impaired under conditions such as inflammation and
oxidative stress that lead to vascular disease.
Methods
Wild
type male C57Bl/6 mice underwent MRI studies using a 7T system (Clinscan,
Bruker). During MRI, mice were anesthetized with 1.25% isoflurane and
maintained at 36 ± 0.5°C using circulating warm water. After localizer imaging,
T1 mapping was performed in a mid-ventricular short-axis slice at baseline and
at 5 and 20 minutes after intravenous injection of LNAME, a NOS inhibitor that
has been shown to rapidly increase coronary microvascular permeability in
rodents [1]. The T1-mapping method used fuzzy-clustering of spiral k-space data
to ensure heart rate independence as previously described [2], and was
accelerated using sparse sampling and compressed-sensing to reduce the scan
time to 7 minutes. Two doses of LNAME, 2 mg/kg (n = 8) and 4 mg/kg (n = 6), were
administered in different imaging sessions.
Results
The
average heart rates at baseline, 5 minutes, and 20 minutes after administering
2mg/kg LNAME were 486 ± 37, 418 ± 17 and 423 ± 25 respectively, and 482 ± 17,
419 ± 13 and 419 ± 13 for 4mg/kg. Figure 1 shows example R1 (1/T1) maps of the
heart acquired before and 5 minutes after injection of 4mg/kg LNAME,
demonstrating the decrease in R1 observed in response to NOS inhibition. Figure
2 shows example myocardial T1 relaxation curves immediately prior to and 5
minutes post LNAME injection (4mg/kg). The estimated T1 values were 1337 ms and
1542 ms for pre- and post-LNAME, respectively, in the example shown. Figure 3
summarizes data from all the mice and shows that T1 mapping after the injection
of LNAME detected a transient increase in T1, as
T1 was elevated at 5 minutes post injection and was returning toward its
baseline value at 20 minutes post injection.
These data suggest a dose dependent effect, as the increase in T1 at 5
minutes after LNAME was greater for the higher dose (ΔT1 = 113 ± 15 ms at
4mg/kg, and ΔT1 = 73 ± 20 ms at 2mg/kg), however only ΔT1 at 4mg/kg LNAME vs. baseline
reached statistical significance (ANOVA on ranks, p<0.05).
Conclusions and Discussion
We
showed, for the first time, that native T1 mapping detects increased myocardial
T1 after administration of LNAME, a NOS inhibitor. As LNAME is known to increase coronary
microvascular permeability [1], the increased T1 is likely due to an increase
in myocardial water content. NOS inhibition leads to vasoconstriction and
decreased coronary blood flow [3], thus it is unlikely that the increase in T1
is due to an increase in blood volume. These methods are likely probing eNOS
regulation of coronary microvascular permeability, which may represent a novel
means of noninvasively assessing the health of the coronary endothelium. Future
studies in eNOS knockout mice and mouse models of diabetes will elucidate the
mechanisms underlying these observations and will test whether these methods can
detect coronary microvascular disease. These methods can potentially be
translated for use in humans, as NOS inhibition with LNAME has been performed
previously at 4mg/kg in human subjects [4].
Acknowledgements
This
work was funded by NIH R01 EB001763.References
1.
Filep J, et al., BJP 1993; 108(2): 323-326.
2.
Vandsburger MH, et al., MRM 2010; 63(3):648-657.
3. Garcia JL, et al., BJP 1992; 106(3): 563-7
4. Frandsenn U, et al., J Physiol 2001; 531(1): 257-264.