Current clinical imaging techniques offer only limited assessment of innate immune cell driven inflammation, which is an emerging therapeutic target in myocardial infarction. However, macrophages have a defined metabolic phenotype and are highly glycolytic when activated following injury. Here we show that hyperpolarized [1-$$$^{13}$$$C]pyruvate imaging specifically detects this phenotype, which is altered by pharmacological blockade that modulates monocyte/macrophage inflammatory function both in vitro and in vivo. We conclude that cardiac hyperpolarized [1-$$$^{13}$$$C]lactate several days post insult reflects immunology, and not necessarily ischaemia.
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