Acute hypertensive stress imaged by cardiac hyperpolarized [1‐ 13 C]pyruvate magnetic resonance

Autor: Esben Søvsø Szocska Hansen, Hans Erik Bøtker, Marie A. Schroeder, Henrik Wiggers, Hans Stødkilde-Jørgensen, Rasmus Stilling Tougaard, Won Yong Kim, Christoffer Laustsen, Jakob Lindhardt
Rok vydání: 2018
Předmět:
Zdroj: Magnetic Resonance in Medicine. 80:2053-2061
ISSN: 1522-2594
0740-3194
DOI: 10.1002/mrm.27164
Popis: Purpose Deranged metabolism is now recognized as a key causal factor in a variety of heart diseases, and is being studied extensively. However, invasive methods may alter metabolism, and conventional imaging techniques measure tracer uptake but not downstream metabolism. These challenges may be overcome by hyperpolarized MR, a noninvasive technique currently crossing the threshold into human trials. The aim of this study was to image metabolic changes in the heart in response to endogastric glucose bolus and to acute hypertension. Methods Five postprandial pigs were scanned with hyperpolarized [1-13 C]pyruvate cardiac MR at baseline, after oral glucose bolus, and after infusion of angiotensin-II. Results No effect of glucose bolus was seen using hyperpolarized [1-13 C]pyruvate MR despite changes in circulating substrates. During angiotensin-II infusion, blood pressure increased 179% (P = 0.008) and ejection fraction decreased from 54 ± 2% to 47 ± 6% (P = 0.03) The hemodynamic changes were accompanied by increases in the hyperpolarized [1-13 C]pyruvate MR derived ratios of lactate/alanine (from 0.58 ± 0.13 to 0.78 ± 0.06, P = 0.03) and bicarbonate/alanine (from 0.55 ± 0.12 to 0.91 ± 0.14, P = 0.007). Conclusion Glucose loading did not alter cardiac metabolism, but during acute hypertensive stress, cardiac aerobic, carbohydrate metabolism, and pyruvate-lactate exchange was altered. Hyperpolarized MR allows noninvasive evaluation of acute changes in cardiac metabolism. However, hemodynamics must be taken into account when interpreting the results.
Databáze: OpenAIRE
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