# Manganese-based Contrast Agent for Cardiovascular MRI

> **NIH NIH R44** · REVEAL PHARMA · 2024 · $1,030,766

## Abstract

ABSTRACT
Cardiovascular disease is the leading cause of morbidity and death, representing 1 in 3 deaths in the United
States, and 18.6 million deaths globally annually. Contrast enhanced magnetic resonance imaging (MRI) and
computed tomography (CT) play a key role in managing heart disease by enabling non-invasive assessment of
myocardial perfusion, infarction, and viability. Cardiac imaging is the fastest growing segment of the MRI market,
with recent landmark trials such as MR-INFORM demonstrating equivalence of contrast enhanced MRI to life
saving invasive catheterization procedures, and SCD-HeFT demonstrating prognostic value in predicting
cardiovascular adverse events. Unfortunately, both iodinated CT radiocontrast and gadolinium-based MRI
contrast agents pose safety risks to patients with renal impairment. Iodinated contrast media can cause acute
and irreversible kidney injury to renally impaired patients. Gadolinium-based contrast agents (GBCAs) can trigger
nephrogenic systemic fibrosis (NSF) in renally impaired patients and all deposit Gd in brain and bone. Cardiac
and renal output are inextricably linked and chronic kidney disease (CKD) patients suffer cardiovascular co-
morbidities at a rate disproportionately high compared to the general population (~25% of ischemic heart disease
population). When imaging heart disease patients with CKD, clinicians must choose between limited radiologic
information or placing the patient at higher risk for complications by using a GBCA.
 Reveal Pharmaceuticals is addressing this challenge by developing RVP-001, a gadolinium-free extracellular
fluid MRI contrast agent. RVP-001 is a stable manganese chelate with relaxivity and pharmacokinetics similar to
GBCAs resulting in equivalent imaging properties. RVP-001 recently completed the in clinic portion of an NIH-
funded Phase 1 clinical trial (NCT05413668). Our ultimate goal is to develop RVP-001 for multiple indications
(CNS, cardiac, angiography, breast) for both renally impaired subjects and the general patient population.
 The objective of this Phase II SBIR proposal is to perform non-clinical imaging and late phase enabling
toxicology experiments in support of a cardiac indication. This work builds upon our recently completed NHLBI-
funded Phase I project (R43HL156713), which demonstrated that RVP-001 is diagnostically equivalent to GBCA
to characterize acute myocardial infarction (MI) in pigs. Here, we will evaluate RVP-001 in the contexts of chronic
myocardial infarction and diffuse myocardial fibrosis that recapitulate human heart failure with reduced ejection
fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), respectively. We posit that an equal
dose of RVP-001 will perform similarly to GBCA given at the indicated dose, that superior cardiac imaging can
be achieved through a larger dose of RVP-001, and that regulatory bodies would be receptive to a RVP-001
dose indication that is larger than GBCAs. The late phase enablin...

## Key facts

- **NIH application ID:** 10846650
- **Project number:** 5R44HL156713-03
- **Recipient organization:** REVEAL PHARMA
- **Principal Investigator:** Vera Hoffman
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,030,766
- **Award type:** 5
- **Project period:** 2020-12-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10846650

## Citation

> US National Institutes of Health, RePORTER application 10846650, Manganese-based Contrast Agent for Cardiovascular MRI (5R44HL156713-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10846650. Licensed CC0.

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