Evaluation of presence of and vulnerability to atrial fibrillation and other indications using matrix metalloproteinase-based imaging
The invention provides, in some embodiments, methods relating to assessing increased risk of developing atrial fibrillation (AF), and/or the likelihood of responding to particular AF therapies using imaging agents comprising an MMP inhibitor linked to an imaging moiety. The invention further provides methods for evaluating the presence of the risk of developing other cardiovascular conditions and assessing the effectiveness of treatment or other intervention for such conditions by determining MMP levels.
1. A method of evaluating risk of developing atrial fibrillation as a primary event comprising:
administering, to a subject, imaging agent 99m Tc-RP805:
wherein TPPTS is 3,3′,3″-phosphanetriyltris(benzenesulfonic acid) trisodium salt, and
acquiring an image of the atria or the aortic valve region of the subject,
wherein the image indicates an aggregate level of MMP comprising MMP-2, MMP-9 and MMP-14 in the atria or the aortic valve region of the subject, and
wherein an aggregate level of MMP in the atria or the aortic valve region of the subject above control is indicative of an increased risk of developing atrial fibrillation.
2. A method for evaluating risk of developing atrial fibrillation recurrence comprising:
administering to a subject previously diagnosed with atrial fibrillation and previously treated for atrial fibrillation, imaging agent 99m Tc-RP805:
wherein TPPTS is 3,3′,3″-Phosphanetriyltris(benzenesulfonic acid) trisodium salt, and
acquiring an image of the atria or the aortic valve region of the subject,
wherein the image indicates an aggregate level of MMP comprising MMP-2, MMP-9 and MMP-14 in the atria or the aortic valve region of the subject, and
wherein an aggregate level of MMP in the atria or the aortic valve region of the subject above control is indicative of an increased risk of atrial fibrillation recurrence.
3. The method of claim 2 , wherein the atrial fibrillation recurrence is atrial fibrillation recurrence following cardioversion therapy.
4. A method for identifying a subject having a history of atrial fibrillation that is likely to respond to treatment with an implantable pacer, pharmacological rate control therapy, pharmacological rhythm control therapy, or ablation therapy, comprising:
administering, to a subject previously diagnosed with atrial fibrillation, imaging agent 99m Tc-RP805:
wherein TPPTS is 3,3′,3″-Phosphanetriyltris(benzenesulfonic acid) trisodium salt; and
acquiring an image of the atria or the aortic valve region of the subject,
wherein the image indicates an aggregate level of MMP comprising MMP-2, MMP-9 and MMP-14 in the atria or the aortic valve region of the subject, and
wherein an aggregate level of MMP in the atria or the aortic valve region of the subject above control identifies a subject that is likely to respond to treatment with an implantable pacer, pharmacological rate control therapy, pharmacological rhythm control therapy, or ablation therapy.
5. The method of claim 4 , wherein the subject has experienced one atrial fibrillation event.
6. The method of claim 4 , wherein the subject has experienced recurrent atrial fibrillation.
7. The method of claim 1 , wherein the image of the atria is a left atrial image.
8. The method of claim 1 , wherein the subject is a human subject.
9. The method of claim 1 , wherein the subject has experienced a myocardial infarction.
10. The method of claim 1 , further comprising determining a measure of myocardial perfusion in the subject, wherein determining a measure of myocardial perfusion in the subject comprises administering to the subject a myocardial perfusion imaging agent and obtaining an image of myocardial perfusion.
11. The method of claim 4 , wherein the image of the atria is a left atrial image.
12. The method of claim 4 , wherein the subject is a human subject.
13. The method of claim 4 , wherein the subject does not exhibit the condition of myocardial fibrosis.
14. The method of claim 4 , wherein the subject does not exhibit the condition of myocardial remodeling.
15. The method of claim 4 , wherein the subject has experienced a myocardial infarction.
16. The method of claim 4 , further comprising determining a measure of myocardial perfusion in the subject, wherein determining a measure of myocardial perfusion in the subject comprises administering to the subject a myocardial perfusion imaging agent and obtaining an image of myocardial perfusion.