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1073 Short term safety and efficacy of manganese chloride cardiovascular magnetic resonance imaging in humans

Introduction

Manganese chloride (MnCl2) rapidly releases free Mn2+ in the blood allowing for its active intracellular uptake by myocytes thus making it a potentially ideal candidate for perfusion and viability studies of the myocardium. However, MnCl2 toxicity might reduce the clinical effectiveness of the substance as a contrast agent. Therefore, we designed this study to investigate for the first time in humans the safety and efficacy of a rapid infusion of MnCl2 for cardiovascular magnetic resonance (CMR) imaging.

Methods

Fifteen normal volunteers underwent a CMR exam on a commercial 1.5 T scanner. Before the infusion, evaluation of cardiac function was performed with a short axis mid-ventricular slice being chosen for the signal intensity studies. Images of this slice were obtained using a 2D and 3D gradient-echo inversion recovery (GRE-IR) sequence, a phase-sensitive IR sequence and a single breath-hold segmented IR prepared steady-state precession acquisition for T1 calculations. MnCl2 was infused in three minutes at a total dose of 5 μMol/kg. Immediately after the infusion, at 15 and 30 minutes new images were obtained and cardiac function was re-evaluated.

Results

There was a significant decrease in T1 values compared to baseline, sustained up to 30 minutes after the MnCl2 infusion (Table 1). The 2D GRE-IR sequence showed the greatest relative increase in signal intensity compared to the other sequences (Figure 1). There was a slight increase in systolic pressure and heart rate after three and four minutes of the infusion with normalization of these parameters thereafter. Patients showed good tolerance to MnCl2 with no major adverse events, despite all patients reporting transient facial flush.

Figure 1
figure1

2D GRE-IR image at pre-injection (A), 0 minutes after (B), 15 minutes (C) and 30 minutes (D).

Table 1 Table 1

Conclusion

In the short term, MnCl2 appears safe for human use. It effectively decreases myocardium T1, maintaining this effect for a relatively long period of time and allowing for the development of new imaging strategies in CMR.

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Correspondence to Juliano L Fernandes.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fernandes, J.L., Storey, P., da Silva, A.A. et al. 1073 Short term safety and efficacy of manganese chloride cardiovascular magnetic resonance imaging in humans. J Cardiovasc Magn Reson 10, A198 (2008). https://doi.org/10.1186/1532-429X-10-S1-A198

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Keywords

  • Cardiovascular Magnetic Resonance
  • Major Adverse Event
  • Rapid Infusion
  • Intracellular Uptake
  • Cardiovascular Magnetic Resonance Imaging