Hyperpolarized [1-13C]pyruvate Magnetic Resonance Imaging Identifies Metabolic Phenotypes in Patients with Heart Failure.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-09-11 DOI:10.1016/j.jocmr.2024.101095

Steen Hylgaard Joergensen,Esben Soevsoe S Hansen,Nikolaj Bøgh,Lotte Bonde Bertelsen,Rasmus Stilling Tougaard,Peter Bisgaard Staehr,Christoffer Laustsen,Henrik Wiggers

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引用次数: 0

Abstract

BACKGROUND Hyperpolarized [1-13C]pyruvate magnetic resonance imaging (HP MRI) visualizes key steps in myocardial metabolism. The present study aimed to examine patients with heart (HF) using HP MRI. METHODS A cross-sectional study of patients with HF and healthy controls using HP MRI. Metabolic imaging was obtained using a cardiac-gated spectral-spatial excitation with spiral read-out acquisition. The metabolite signal was analyzed for lactate, bicarbonate, and the alanine signal. Metabolite signal was normalized to the total carbon signal (TC). At the one-year follow-up, echocardiography was performed in all patients and HP MRI in two patients. RESULTS We included six patients with ischemic heart disease (IHD), six with dilated cardiomyopathy and six healthy controls. In patients, left ventricular ejection fraction (LVEF) correlated with lactate/bicarbonate (r = -0.6, p = 0.03) and lactate/TC (r = -0.7, p = 0.01). In patients with LVEF < 30%, lactate/TC was increased (p = 0.01) and bicarbonate/TC reduced (p = 0.03). Circumferential strain correlated with metabolite ratios: lactate/bicarbonate, r = 0.87 (p = 0.0002); lactate/TC, r = 0.85 (p = 0.0005); bicarbonate/TC, r = -0.82 (p = 0.001). In patients with IHD, a strong correlation was found between baseline metabolite ratios and the change in LVEF at follow-up: lactate/bicarbonate (p = 0.001); lactate/TC (p = 0.011); and bicarbonate/TC (p = 0.012). CONCLUSIONS This study highlighted the ability of HP MRI to detect changes in metabolism in HF. HP MRI has potential for metabolic phenotyping of patients with HF and for predicting treatment response. TRIAL REGISTRATION EUDRACT, 2018-003533-15. Registered 4 December 2018, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15.

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超极化[1-13C]丙酮酸磁共振成像可识别心力衰竭患者的代谢表型。

背景超极化[1-13C]丙酮酸磁共振成像（HP MRI）可显示心肌代谢的关键步骤。本研究旨在使用 HP MRI 对心脏（HF）患者进行检查。代谢成像采用心脏门控频谱空间激发和螺旋读出采集。代谢物信号分析包括乳酸、碳酸氢盐和丙氨酸信号。代谢物信号与总碳信号（TC）进行归一化处理。随访一年时，对所有患者进行了超声心动图检查，对两名患者进行了 HP MRI 检查。在患者中，左心室射血分数（LVEF）与乳酸/碳酸氢盐（r = -0.6，p = 0.03）和乳酸/TC（r = -0.7，p = 0.01）相关。在 LVEF < 30% 的患者中，乳酸/碳酸氢盐增加（p = 0.01），碳酸氢盐/碳酸氢盐减少（p = 0.03）。圆周应变与代谢物比率相关：乳酸/碳酸氢盐，r = 0.87 (p = 0.0002)；乳酸/TC，r = 0.85 (p = 0.0005)；碳酸氢盐/TC，r = -0.82 (p = 0.001)。在 IHD 患者中，基线代谢物比率与随访时 LVEF 的变化之间存在很强的相关性：乳酸/碳酸氢盐（p = 0.001）；乳酸/TC（p = 0.011）；碳酸氢盐/TC（p = 0.012）。HP MRI具有对HF患者进行代谢表型分析和预测治疗反应的潜力.TRIAL REGISTRATIONEUDRACT，2018-003533-15。2018年12月4日注册，https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15。

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.