Tropoelastin: A novel marker for atherosclerotic plaque instability

Elastolysis and ineffective elastogenesis favour the accumulation of tropoelastin, rather than cross-linked elastin, in atherosclerotic plaques and could provide a new marker for plaque progression and instability. We developed a novel tropoelastin-binding gadolinium-based MRI contrast agent and demonstrated the feasibility of molecular imaging of tropoelastin in rabbits. Rupture-prone plaques had significantly higher uptake of the contrast agent compared with stable plaques and quantitive assessment of tropoelastin allowed detection of rupture-prone plaques with high sensitivity, specificity, positive and negative predictive values. Ex vivo analyses confirmed the MRI findings and showed that uptake of the contrast agent was specific for tropoelastin.