Improved metabolic imaging of the heart
CMR shows myocardial viability, perfusion (blood supply) and contractility. Hyperpolarisation methods are enabling detection of metabolic substrates in the heart such as high-energy phosphate compounds (e.g. pyruvate). Hyperpolarisation is a technique where the signal intensity from the C-13 labelled substrate is detected to estimate normal and abnormal metabolism in real time. The problem with hyperpolarisation is that it is short-lived and requires high scanning efficiency within a short time frame. The ACCELCMR project worked on developing and optimising in vivo metabolic imaging of the heart through CMR scan acceleration and better carbon-13 (C-13) hyperpolarisation. Improved polarisation levels of C-13 labelled pyruvate led to better substrate detection. Accelerated imaging techniques were successfully developed, optimised and tested. The results of optimised signal sampling were faster and high-resolution perfusion imaging, metabolic imaging and contractile functional imaging. Metabolic imaging will provide unparalleled non-invasive insight into the underlying mechanisms occurring during heart conditions where there is a restricted supply of oxygen and injury when blood supply is restored. Further research to optimise instrumentation could improve knowledge about metabolic defects in the heart. This could provide the key to effective treatment for CVD to limit mortality and improve patient outcomes as well as quality of life.
Keywords
Cardiovascular disease, magnetic resonance imaging, myocardial, hyperpolarisation, metabolic substrates, pyruvate, carbon-13, reperfusion injury, metabolic derangement
