From molecules to myofibers: multiscale imaging of the myocardium.

Pathology in the heart can be examined at several scales, ranging from the molecular to the macroscopic. Traditionally, fluorescence-based techniques such as flow cytometry have been used to study the myocardium at the molecular, cellular, and microscopic levels. Recent advances in magnetic resonance imaging (MRI), however, have made it possible to image certain cellular and molecular events in the myocardium noninvasively in vivo. In addition, diffusion MRI has been used to image myocardial fiber architecture and microstructure in the intact heart. Diffusion MRI tractography, in particular, is providing novel insights into myocardial microsctructure in both health and disease. Recent developments have also been made in fluorescence imaging, making it possible to image fluorescent probes in the heart of small animals noninvasively in vivo. Moreover, techniques have been developed to perform in vivo fluorescence tomography of the mouse heart. These advances in MRI and fluorescence imaging allow events in the myocardium to be imaged at several scales linking molecular changes to alterations in microstructure and microstructural changes to gross function. A complete and integrated picture of pathophysiology in the myocardium is thus obtained. This multiscale approach has the potential to be of significant value not only in preclinical research but, ultimately, in the clinical arena as well.