Marie Allen Schroeder1, 2, Angus Z. Lau1, 3, Albert Chen4, Kim Connelly1, 5, Xudong Hu5, Jennifer Barry1, Damian J. Tyler2, Kieran Clarke2, Graham A. Wright1,3, Chuck H. Cunningham1,3
1Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario , Canada; 2Physiology, Anatomy & Genetics, University of Oxford, Oxford, Oxfordshire, United Kingdom; 3Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; 4GE-Healthcare, Toronto, Ontario, Canada; 5Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital , Toronto, Ontario, Canada
The aim of this study was to use hyperpolarized 13C MRI and MRS to monitor cardiac substrate utilization alongside structure and function, measured using standard cine-MRI, throughout HF progression. Metabolism of [2-13C]pyruvate to 13C-glutamate was reduced by 59% at an early stage in HF, with no change to PDH flux, indicating that 13C-glutamate relative to H13CO3- production could be an early marker of disease. Carbohydrate oxidation via PDH was maintained until end-stage HF, at which point PDH flux was reduced by 62%. Hyperpolarised 13C MR may be useful to characterize HF progression, and to diagnose disease, in patients.