Angus Z. Lau1, 2, Albert P. Chen3, William Dominguez-Viqueira2, Marie A. Schroeder2, 4, Yiping Gu2, Jennifer Barry2, John Graham2, 5, Nilesh Ghugre2, Graham A. Wright1, 2, Charles H. Cunningham1, 2
1Dept. of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; 2Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada; 3GE Healthcare, Toronto, Ontario, Canada; 4Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom; 5Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada
A dual respiratory and cardiac-gated, multi-slice, single-shot spiral frequency-specific 13C pulse sequence was used to characterize cardiac metabolic remodeling following acute myocardial infarction in vivo in a porcine ischemia-reperfusion model. We observed two distinct phenotypes, corresponding to myocardial stunning and infarction, with distinct metabolic remodeling patterns revealed by hyperpolarized 13C imaging. PDH flux was reduced following LAD occlusion, with recovery in stunned myocardium. Elevated myocardial lactate was observed in the peri-infarct region, presumably reflecting the potential viability of the myocardium in that area. This work may potentially enable a clinically feasible assessment of salvageable myocardium (the area-at-risk) in myocardial infarction.