超极化[1-C]丙酮酸心血管磁共振成像可识别心力衰竭患者的代谢表型。
Hyperpolarized [1-C]pyruvate cardiovascular magnetic resonance imaging identifies metabolic phenotypes in patients with heart failure.
作者信息
Joergensen Steen Hylgaard, Hansen Esben Soevsoe S, Bøgh Nikolaj, Bertelsen Lotte Bonde, Tougaard Rasmus Stilling, Staehr Peter Bisgaard, Laustsen Christoffer, Wiggers Henrik
机构信息
The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
出版信息
J Cardiovasc Magn Reson. 2024;26(2):101095. doi: 10.1016/j.jocmr.2024.101095. Epub 2024 Sep 11.
BACKGROUND
Hyperpolarized [1-C]pyruvate cardiovascular magnetic resonance imaging (HP [1-C]pyruvate CMR) visualizes key steps in myocardial metabolism. The present study aimed to examine patients with heart failure (HF) using HP [1-C]pyruvate CMR.
METHODS
A cross-sectional study of patients with HF and healthy controls using HP [1-C]pyruvate CMR. 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 1-year follow-up, echocardiography was performed in all patients and HP [1-C]pyruvate 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 [1-C]pyruvate CMR to detect changes in metabolism in HF. HP [1-C]pyruvate CMR has the potential for metabolic phenotyping of patients with HF and for predicting treatment response.
TRIAL REGISTRATION
EUDRACT, 2018-003533-15. Registered December 4, 2018, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15.
背景
超极化[1 - C]丙酮酸心血管磁共振成像（HP [1 - C]丙酮酸CMR）可显示心肌代谢的关键步骤。本研究旨在使用HP [1 - C]丙酮酸CMR检查心力衰竭（HF）患者。
方法
一项对HF患者和健康对照者使用HP [1 - C]丙酮酸CMR的横断面研究。采用心脏门控频谱空间激发和螺旋读出采集进行代谢成像。分析代谢物信号中的乳酸、碳酸氢盐和丙氨酸信号。将代谢物信号标准化为总碳信号（TC）。在1年随访时，对所有患者进行超声心动图检查，对两名患者进行HP [1 - C]丙酮酸MRI检查。
结果
我们纳入了6例缺血性心脏病（IHD）患者、6例扩张型心肌病患者和6名健康对照者。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/TC升高（p = 0.01），碳酸氢盐/TC降低（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，发现基线代谢物比率与随访时LVEF的变化之间存在强相关性：乳酸/碳酸氢盐（p = 0.001）、乳酸/TC（p = 0.011）和碳酸氢盐/TC（p = 0.012）。
结论
本研究突出了HP [1 - C]丙酮酸CMR检测HF患者代谢变化的能力。HP [1 - C]丙酮酸CMR具有对HF患者进行代谢表型分析和预测治疗反应的潜力。
试验注册
EUDRACT，2018 - 003533 - 15。于2018年12月4日注册，https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15 。
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