Acute myocardial infarction is one of the leading causes of death in the western world.
Despite major improvements in myocardial reperfusion with sophisticated percutaneous coronary
intervention technologies and new antithrombotic agents, there is still no effective therapy for preventing
post- infarction myocardial injury and remodeling. Death of cardiomyocytes following ischemia
results in “danger signals” that elicit an inflammatory reaction to remove cell debris and
form scar tissue. Optimal healing of the damaged myocardial tissue requires a coordinated cellular
response for sufficient wound healing and scar formation. However, if this inflammatory reaction
is overactive or incompletely resolved, adverse left ventricular remodeling and heart failure may occur.
Treatment aimed at the modulation of the post-MI inflammatory response has been widely pursued
and investigated. Although improved infarct healing was shown in many experimental preclinical
studies, to date, clinical trials using anti-inflammatory treatment strategies have been far less
successful. Clearly, a need exists for predicting and selecting patients at risk and selecting the most
appropriate therapy for individual patients. To this end, imaging of the post-MI response has been
a topic of significant interest. In this review, we first discuss the clinical complications resulting
from myocardial inflammation following AMI and the need for non-invasive imaging techniques
using radiolabeled tracers. We then discuss the inflammatory reaction cascade following acute myocardial
infarction, the inflammatory reaction cascade following acute myocardial infarction focusing
on inflammatory cell types involved herein, and potential imaging targets for identifying these
cells during the inflammatory process. In addition, we discuss specific characteristics and limitations
of various preclinical animal models for ischemic heart disease since they are crucial in the development
and evaluation of the imaging techniques. Finally, we discuss the need for non-invasive
imaging approaches using radiolabeled tracers.