Trial Outcomes & Findings for Clinical Trial of Manganese-Enhanced MRI (MEMRI) to Assess Peri-Infarct Injury (NCT NCT02933034)

NCT ID: NCT02933034

Last Updated: 2020-02-17

Results Overview

MEMRI is an assessment of non-viable myocardial tissue and evaluates core infarct size. DEMRI is an assessment of fibrotic tissue and evaluates the total infarct size. The difference between these two measurements evaluates the size of peri-infarct region consisting of mixed components of injured but viable cardiomyocytes and fibrosis.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

33 participants

Primary outcome timeframe

Day of MEMRI and DEMRI scans (up to 3 hours per scan, performed on the same day or up to 7 days apart)

Results posted on

2020-02-17

Participant Flow

Participant milestones

Participant milestones
Measure
Coronary Disease Patients
Participants receive 2 cardiac MRI procedures: manganese-enhanced MRI (MEMRI; manganese 0.28 mL/kg as reagent); and delayed-enhanced MRI (DEMRI; gadolinium 0.2 mmol/kg as reagent).
Overall Study
STARTED
33
Overall Study
Received Both MEMRI and DEMRI Scans
24
Overall Study
COMPLETED
24
Overall Study
NOT COMPLETED
9

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Clinical Trial of Manganese-Enhanced MRI (MEMRI) to Assess Peri-Infarct Injury

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Age, Continuous
63.0 years
STANDARD_DEVIATION 7.6 • n=93 Participants
Sex: Female, Male
Female
3 Participants
n=93 Participants
Sex: Female, Male
Male
21 Participants
n=93 Participants
Race/Ethnicity, Customized
Caucasian
11 Participants
n=93 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=93 Participants
Race/Ethnicity, Customized
South Asian
6 Participants
n=93 Participants
Race/Ethnicity, Customized
Latino
3 Participants
n=93 Participants
Region of Enrollment
United States
24 participants
n=93 Participants

PRIMARY outcome

Timeframe: Day of MEMRI and DEMRI scans (up to 3 hours per scan, performed on the same day or up to 7 days apart)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

MEMRI is an assessment of non-viable myocardial tissue and evaluates core infarct size. DEMRI is an assessment of fibrotic tissue and evaluates the total infarct size. The difference between these two measurements evaluates the size of peri-infarct region consisting of mixed components of injured but viable cardiomyocytes and fibrosis.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Infarct Size of MEMRI Versus DEMRI Scans
MEMRI
12.2 percentage of left ventricle
Standard Deviation 7.3
Infarct Size of MEMRI Versus DEMRI Scans
DEMRI
18.9 percentage of left ventricle
Standard Deviation 11.9

SECONDARY outcome

Timeframe: Before, during, and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Systolic blood pressure during MEMRI scan as a measure of manganese contrast reagent safety. Normal reference range: 90-120 mmHg.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Systolic Blood Pressure
Baseline
121.8 mmHg
Standard Deviation 16.4
Systolic Blood Pressure
During MRI
160.9 mmHg
Standard Deviation 24.4
Systolic Blood Pressure
Post MRI
124.4 mmHg
Standard Deviation 18.3

SECONDARY outcome

Timeframe: Before,during, and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Diastolic blood pressure during MEMRI scan as a measure of manganese contrast reagent safety. Normal reference range: 60-80 mmHg.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Diastolic Blood Pressure
Baseline
71.8 mmHg
Standard Deviation 9.1
Diastolic Blood Pressure
During MRI
92.6 mmHg
Standard Deviation 10.8
Diastolic Blood Pressure
Post MRI
66.2 mmHg
Standard Deviation 10.0

SECONDARY outcome

Timeframe: Before,during, and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Heart rate during MEMRI scan as a measure of manganese contrast reagent safety. Normal reference range: 60 and 100 beats per minute.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Heart Rate
Baseline
66.3 beats per minute
Standard Deviation 9.9
Heart Rate
During MRI
82.8 beats per minute
Standard Deviation 15.1
Heart Rate
Post MRI
66.2 beats per minute
Standard Deviation 10.0

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

QT interval during MEMRI scan as a measure of manganese contrast reagent safety. QT is a measurement of heart function that is dependent on heart rate, so QTc is mainly used for diagnosis rather than QT. Normal reference range was considered to be 360-450 milliseconds for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
QT Interval
Baseline
414.7 milliseconds
Standard Deviation 40.1
QT Interval
Post MRI
412.6 milliseconds
Standard Deviation 38.2

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Corrected QT (QTc) interval during MEMRI scan as a measure of manganese contrast reagent safety. QTc is a measurement of heart function and is mainly used for diagnosis rather than QT, because QT is dependent on heart rate. Normal reference range was considered to be 360-450 milliseconds for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Corrected QT (QTc)
Baseline
435.7 milliseconds
Standard Deviation 34.5
Corrected QT (QTc)
Post MRI
440.5 milliseconds
Standard Deviation 37.3

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

ALT levels during MEMRI scan as a measure of manganese contrast reagent safety. ALT is a measurement of liver function. Normal reference range was considered to be \<60 U/L for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Alanine Aminotransferase (ALT)
Baseline
37.8 U/L
Standard Deviation 18.4
Alanine Aminotransferase (ALT)
Post MRI
35.1 U/L
Standard Deviation 12.6

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

AST levels during MEMRI scan as a measure of manganese contrast reagent safety. AST is a measurement of liver function. Normal reference range was considered to be \<40 U/L for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Aspartate Aminotransferase (AST)
Baseline
26.1 U/L
Standard Deviation 12.4
Aspartate Aminotransferase (AST)
Post MRI
25.4 U/L
Standard Deviation 9.1

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

ALP levels during MEMRI scan as a measure of manganese contrast reagent safety. ALP is a measurement of liver function. Normal reference range was considered to be \<40-130 U/L for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Alkaline Phosphatase (ALP)
Baseline
80.8 U/L
Standard Deviation 21.9
Alkaline Phosphatase (ALP)
Post MRI
79.8 U/L
Standard Deviation 26.7

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Total bilirubin levels during MEMRI scan as a measure of manganese contrast reagent safety. Total bilirubin is a measurement of liver function. Normal reference range was considered to be \<1.4 mg/dL for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Total Bilirubin
Baseline
0.58 mg/dL
Standard Deviation 0.21
Total Bilirubin
Post MRI
0.65 mg/dL
Standard Deviation 0.30

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

Creatinine levels during MEMRI scan as a measure of manganese contrast reagent safety. Creatinine is a measurement of kidney function. Normal reference range was considered to be 0.50-1.20 mg/dL for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Creatinine
Baseline
1.04 mg/dL
Standard Deviation 0.23
Creatinine
Post MRI
1.10 mg/dL
Standard Deviation 0.19

SECONDARY outcome

Timeframe: Before and after MEMRI scan (up to 3 hours)

Population: Participants who had both MEMRI and DEMRI scans are included in the analysis

eGFR levels during MEMRI scan as a measure of manganese contrast reagent safety. eGFR is a measurement of kidney function. Normal reference range was considered to be \>60 ml/min/1.73m\^2 for this study.

Outcome measures

Outcome measures
Measure
Coronary Disease Patients
n=24 Participants
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as reagent); and DEMRI (gadolinium 0.2 mmol/kg as reagent).
Estimated Glomerular Filtration Rate (eGFR)
Pre MRI
75.4 mL/min/1.73m^2
Standard Deviation 20.5
Estimated Glomerular Filtration Rate (eGFR)
Post MRI
70.5 mL/min/1.73m^2
Standard Deviation 16.0

Adverse Events

Coronary Disease Patients

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Coronary Disease Patients
n=33 participants at risk
Participants receive 2 cardiac MRI procedures: MEMRI (manganese 0.28 mL/kg as a reagent); and DEMRI (gadolinium 0.2 mmol/kg as a reagent).
Gastrointestinal disorders
abdominal discomfort
3.0%
1/33 • Baseline to end of study (average 616 days)
Gastrointestinal disorders
abdominal pain
9.1%
3/33 • Baseline to end of study (average 616 days)
Nervous system disorders
anxiety
3.0%
1/33 • Baseline to end of study (average 616 days)
General disorders
chest pain
6.1%
2/33 • Baseline to end of study (average 616 days)
Gastrointestinal disorders
constipation
3.0%
1/33 • Baseline to end of study (average 616 days)
General disorders
fatigue
6.1%
2/33 • Baseline to end of study (average 616 days)
Vascular disorders
flushing
27.3%
9/33 • Baseline to end of study (average 616 days)
Metabolism and nutrition disorders
hypoglycemia
3.0%
1/33 • Baseline to end of study (average 616 days)
Nervous system disorders
lip numbness
3.0%
1/33 • Baseline to end of study (average 616 days)
General disorders
malaise
3.0%
1/33 • Baseline to end of study (average 616 days)
Gastrointestinal disorders
nausea
9.1%
3/33 • Baseline to end of study (average 616 days)
General disorders
mild discomfort
3.0%
1/33 • Baseline to end of study (average 616 days)
General disorders
mild jaw pain
3.0%
1/33 • Baseline to end of study (average 616 days)
General disorders
mild weakness of feet
3.0%
1/33 • Baseline to end of study (average 616 days)

Additional Information

Phillip C. Yang

Stanford University

Phone: (650) 498-8008

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place