Restoration of coronary blood flow after a heart attack can cause reperfusion injury potentially leading to impaired cardiac function, adverse tissue remodeling and heart failure. Iron is an essential biometal that may have a pathologic role in this process. There is a clinical need for a precise noninvasive method to detect iron for risk stratification of patients and therapy evaluation. Here, we report that magnetic susceptibility imaging in a large animal model shows an infarct paramagnetic shift associated with duration of coronary artery occlusion and the presence of iron. Iron validation techniques used include histology, immunohistochemistry, spectrometry and spectroscopy. Further mRNA analysis shows upregulation of ferritin and heme oxygenase. While conventional imaging corroborates the findings of iron deposition, magnetic susceptibility imaging has improved sensitivity to iron and mitigates confounding factors such as edema and fibrosis. Myocardial infarction patients receiving reperfusion therapy show magnetic susceptibility changes associated with hypokinetic myocardial wall motion and microvascular obstruction, demonstrating potential for clinical translation.

心脏病发作后冠状动脉血流的恢复可能导致再灌注损伤，可能导致心脏功能受损、组织重塑不良和心力衰竭。铁是一种重要的生物金属，可能在此过程中发挥病理作用。临床需要一种精确的非侵入性方法来检测铁，以对患者进行风险分层和治疗评估。在这里，我们报告大型动物模型中的磁化率成像显示与冠状动脉闭塞持续时间和铁的存在相关的梗塞顺磁位移。使用的铁验证技术包括组织学、免疫组织化学、光谱测定法和光谱学。进一步的 mRNA 分析显示铁蛋白和血红素加氧酶的上调。虽然传统成像证实了铁沉积的发现，但磁化率成像提高了对铁的敏感性并减轻了水肿和纤维化等混杂因素。接受再灌注治疗的心肌梗塞患者表现出与心肌壁运动减退和微血管阻塞相关的磁化率变化，证明了临床转化的潜力。