Translational models of coronary artery disease, myocardial infarction and heart failure. Development, validation and in vivo imaging studies using positron emission tomography

Coronary artery disease is an atherosclerotic disease, which leads to narrowing of coronary arteries, deteriorated myocardial blood flow and myocardial ischaemia. In acute myocardial infarction, a prolonged period of myocardial ischaemia leads to myocardial necrosis. Necrotic myocardium is replaced with scar tissue. Myocardial infarction results in various changes in cardiac structure and function over time that results in “adverse remodelling”. This remodelling may result in a progressive worsening of cardiac function and development of chronic heart failure. In this thesis, we developed and validated three different large animal models of coronary artery disease, myocardial ischaemia and infarction for translational studies. In the first study the coronary artery disease model had both induced diabetes and hypercholesterolemia. In the second study myocardial ischaemia and infarction were caused by a surgical method and in the third study by catheterisation. For model characterisation, we used non-invasive positron emission tomography (PET) methods for measurement of myocardial perfusion, oxidative metabolism and glucose utilisation. Additionally, cardiac function was measured by echocardiography and computed tomography. To study the metabolic changes that occur during atherosclerosis, a hypercholesterolemic and diabetic model was used with [18F] fluorodeoxyglucose ([18F]FDG) PET-imaging technology. Coronary occlusion models were used to evaluate metabolic and structural changes in the heart and the cardioprotective effects of levosimendan during post-infarction cardiac remodelling. Large animal models were used in testing of novel radiopharmaceuticals for myocardial perfusion imaging. In the coronary artery disease model, we observed atherosclerotic lesions that were associated with focally increased [18F]FDG uptake. In heart failure models, chronic myocardial infarction led to the worsening of systolic function, cardiac remodelling and decreased efficiency of cardiac pumping function. Levosimendan therapy reduced post-infarction myocardial infarct size and improved cardiac function. The novel 68Ga-labeled radiopharmaceuticals tested in this study were not successful for the determination of myocardial blood flow. In conclusion, diabetes and hypercholesterolemia lead to the development of early phase atherosclerotic lesions. Coronary artery occlusion produced considerable myocardial ischaemia and later infarction following myocardial remodelling. The experimental models evaluated in these studies will enable further studies concerning disease mechanisms, new radiopharmaceuticals and interventions in coronary artery disease and heart failure.

Developing correlative Optical-Photoacustic microscopy for high-resolution in vivo imaging

PhotoAcoustic Imaging (PAI) is a branch in clinical and pre-clinical imaging, that refers to the techniques mapping acoustic signals caused by the absorption of the short laser pulse. This conversion of electromagnetic energy of the light to the mechanical (acoustic) energy is usually called photoacoustic effect. PAI, by combining optical excitation with acoustical detection, is able to preserve the diffraction limited spatial resolution. At the same time, the penetration depth is extended beyond the diffusive limit. The Laser-Scanning PhotoAcoustic Microscope system (LS-PAM) has been developed, that offers the axial resolution of 7.75 µm with the lateral resolution better than 10 µm. The first in vivo imaging experiments were carried out. Thus, in vivo label-free imaging of the mouse ear was performed. The principle possibility to image vessels located in deep layers of the mouse skin was shown. As well as that, a gold printing sample, vasculature of the Chick Chorioallantoic Membrane Assay, Drosophila larvae were imaged by PAI. During the experimental work, a totally new application of PAM was found, in which the acoustic waves, generated by incident light can be used for further imaging of another sample. In order to enhance the performance of the presented system two main recommendation can be offered. First, the current system should be transformed into reflection-mode setup system. Second, a more powerful source of light with the sufficient repetition rate should be introduced into the system.

Consumer neuroscience: usability of brain imaging methods in marketing research

Consumer neuroscience (neuromarketing) is an emerging field of marketing research which uses brain imaging techniques to study neural conditions and processes that underlie consumption. The purpose of this study was to map this fairly new and growing field in Finland by studying the opinions of both Finnish consumers and marketing professionals towards it and comparing the opinions to the current consumer neuroscience literature, and based on that evaluate the usability of brain imaging techniques as a marketing research method. Mixed methods research design was chosen for this study. Quantitative data was collected from 232 consumers and 28 marketing professionals by means of online surveys. Both respondent groups had either neutral opinions or lacked knowledge about the four themes chosen for this study: benefits, limitations and challenges, ethical issues and future prospects of consumer neuroscience. Qualitative interview data was collected from 2 individuals from Finnish neuromarketing companies to deepen insights gained from quantitative research. The four interview themes were the same as in the surveys and the interviewees’ answers were mostly in line with the current literature, although more optimistic about the future of the field. The interviews also exposed a gap between academic consumer neuroscience research and practical level applications. The results of this study suggest that there are still many unresolved challenges and relevant populations either have neutral opinions or lack information about consumer neuroscience. The practical level applications are, however, already being successfully used and this new field of marketing research is growing both globally and in Finland.

Cardiac Imaging in the Diagnosis of Coronary Artery Disease: The Value of Quantitative Imaging of Myocardial Perfusion and Deformation

Atherosclerosis is a chronic and progressive disease of the vasculature. Increasing coronary atherosclerosis can lead to obstructive coronary artery disease (CAD) or myocardial infarction. Computed tomography angiography (CTA) allows noninvasive assessment of coronary anatomy and quantitation of atherosclerotic burden. Myocardial blood flow (MBF) can be accurately measured in absolute terms (mL/g/min) by positron emission tomography (PET) with [15O] H O as a radiotracer. We studied the coronary microvascular dysfunction as a risk factor for future coronary calcification in healthy young men by measuring the coronary flow reserve (CFR) which is the ratio between resting and hyperemic MBF. Impaired vasodilator function was not linked with accelerated atherosclerosis 11 years later. Currently, there is a global interest in quantitative PET perfusion imaging. We established optimal thresholds of [15O] H O PET perfusion for diagnosis of CAD (hyperemic MBF of 2.3 mL/g/min and CFR of 2.5) in the first multicenter study of this type (Turku, Amsterdam and Uppsala). In myocardial bridging a segment of the coronary artery travels inside the myocardium and can be seen as intramural course (CTA) or systolic compression (invasive coronary angiography). Myocardial bridging is frequently linked with proximal atherosclerotic plaques. We used quantitative [15O] H O PET perfusion to evaluate the hemodynamic effects of myocardial bridging. Myocardial bridging was not associated with decreased absolute MBF or increased atherosclerotic burden. Speckle tracking allows quantitative echocardiographic imaging of myocardial deformation. Speckle tracking during dobutamine stress echocardiography was feasible and comparable to subjective wall motion analysis in the diagnosis of CAD. In addition, it correctly risk stratified patients with multivessel disease and extensive ischemia.

Consumer neuroscience: usability of brain imaging methods in marketing research

Consumer neuroscience (neuromarketing) is an emerging field of marketing research which uses brain imaging techniques to study neural conditions and processes that underlie consumption. The purpose of this study was to map this fairly new and growing field in Finland by studying the opinions of both Finnish consumers and marketing professionals towards it and comparing the opinions to the current consumer neuroscience literature, and based on that evaluate the usability of brain imaging techniques as a marketing research method. Mixed methods research design was chosen for this study. Quantitative data was collected from 232 consumers and 28 marketing professionals by means of online surveys. Both respondent groups had either neutral opinions or lacked knowledge about the four themes chosen for this study: benefits, limitations and challenges, ethical issues and future prospects of consumer neuroscience. Qualitative interview data was collected from 2 individuals from Finnish neuromarketing companies to deepen insights gained from quantitative research. The four interview themes were the same as in the surveys and the interviewees’ answers were mostly in line with the current literature, although more optimistic about the future of the field. The interviews also exposed a gap between academic consumer neuroscience research and practical level applications. The results of this study suggest that there are still many unresolved challenges and relevant populations either have neutral opinions or lack information about consumer neuroscience. The practical level applications are, however, already being successfully used and this new field of marketing research is growing both globally and in Finland.