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Hyperpolarized-MRI in Hypertrophic Cardiomyopathy: A Narrative Review.

作者信息

Malik Ali, Kundur Sukruth Pradeep, Sivalokanathan Sanjay

机构信息

Faculty of Life Sciences and Medicine, King's College London, UK.

Mount Sinai Fuster Heart Hospital, Icahn School of Medicine, New York, NY, USA.

出版信息

Clin Med Insights Cardiol. 2025 Aug 29;19:11795468251369234. doi: 10.1177/11795468251369234. eCollection 2025.


DOI:10.1177/11795468251369234
PMID:40895840
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12398660/
Abstract

Hypertrophic cardiomyopathy is a genetically inherited cardiac disorder that presents with diverse clinical phenotypes. It is associated with significant adverse outcomes, including arrhythmias and sudden cardiac death. Current gold-standard diagnostic methods include echocardiography and cardiac magnetic resonance imaging. These imaging modalities are the cornerstone in identifying structural abnormalities and aiding risk stratification. However, they fail to capture the preceding cellular and metabolic disturbances that underpin disease progression. Hyperpolarized magnetic resonance imaging (HP-MRI) is an emerging imaging technique that enables non-invasive and non-ionizing visualization of metabolic pathways. HP-MRI enhances the signal of metabolites like [1-C]pyruvate, providing insights into metabolic pathways. Alterations in the metabolic pathways of cardiomyocytes are central to HCM pathophysiology. HP-MRI may be able to delineate the metabolic consequences of sarcomere mutations and distinguish HCM from phenocopies such as glycogen storage disorders or cardiac amyloidosis. More importantly, it has the potential to detect early metabolic shifts and thus play a role in early diagnosis, personalized risk stratification, and monitoring therapeutic response. Although still in experimental stages with technical challenges, HP-MRI has demonstrated considerable potential in preclinical and small-scale studies, exhibiting effectiveness in the diagnosis and monitoring of malignancies across a substantial number of investigations. Further research focusing on larger cohorts and integrating HP-MRI with traditional cardiovascular imaging may pave the way for its clinical use, as well as risk stratification, in HCM.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e1/12398660/44c73bd8ff0b/10.1177_11795468251369234-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e1/12398660/44c73bd8ff0b/10.1177_11795468251369234-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e1/12398660/44c73bd8ff0b/10.1177_11795468251369234-fig1.jpg

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本文引用的文献

[1]
PET-CT Imaging in Hypertrophic Cardiomyopathy: A Narrative Review on Risk Stratification and Prognosis.

Diagnostics (Basel). 2025-1-8

[2]
Mechano-energetic uncoupling in hypertrophic cardiomyopathy: Pathophysiological mechanisms and therapeutic opportunities.

J Mol Cell Cardiol Plus. 2023-5-6

[3]
Advancements, challenges, and future prospects in clinical hyperpolarized magnetic resonance imaging: A comprehensive review.

Biomed J. 2024-10-21

[4]
Hyperpolarized [1-C]pyruvate cardiovascular magnetic resonance imaging identifies metabolic phenotypes in patients with heart failure.

J Cardiovasc Magn Reson. 2024

[5]
Novel Cardiac Myosin Inhibitor Therapy for Hypertrophic Cardiomyopathy in Adults: A Contemporary Review.

Am J Cardiovasc Drugs. 2024-9

[6]
Hyperpolarized C and P MRS detects differences in cardiac energetics, metabolism, and function in obesity, and responses following treatment.

NMR Biomed. 2024-11

[7]
The abnormalities of free fatty acid metabolism in patients with hypertrophic cardiomyopathy, a single-center retrospective observational study.

BMC Cardiovasc Disord. 2024-6-20

[8]
Integrating Clinical Phenotype With Multiomics Analyses of Human Cardiac Tissue Unveils Divergent Metabolic Remodeling in Genotype-Positive and Genotype-Negative Patients With Hypertrophic Cardiomyopathy.

Circ Genom Precis Med. 2024-6

[9]
Retrofitting the Heart: Explaining the Enigmatic Septal Thickening in Hypertrophic Cardiomyopathy.

Circ Heart Fail. 2024-5

[10]
Targeting MAPK-ERK/JNK pathway: A potential intervention mechanism of myocardial fibrosis in heart failure.

Biomed Pharmacother. 2024-4

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