title: Hyperpolarized 13C Metabolic MRI of the Human Heart: Initial Experience.
abstract: BACKGROUND
  Altered cardiac energetics is known to play an important role in the progression toward heart failure. A noninvasive method for imaging metabolic markers that could be used in longitudinal studies would be useful for understanding therapeutic approaches that target metabolism.
  
  
  OBJECTIVE
  To demonstrate the first hyperpolarized13C metabolic magnetic resonance imaging of the human heart.
  
  
  RESULTS
  Four healthy subjects underwent conventional proton cardiac magnetic resonance imaging followed by13C imaging and spectroscopic acquisition immediately after intravenous administration of a 0.1 mmol/kg dose of hyperpolarized [1-13C]pyruvate. All subjects tolerated the procedure well with no adverse effects reported ≤1 month post procedure. The [1-13C]pyruvate signal appeared within the chambers but not within the muscle. Imaging of the downstream metabolites showed13C-bicarbonate signal mainly confined to the left ventricular myocardium, whereas the [1-13C]lactate signal appeared both within the chambers and in the myocardium. The mean13C image signal:noise ratio was 115 for [1-13C]pyruvate, 56 for13C-bicarbonate, and 53 for [1-13C]lactate.
  
  
  CONCLUSIONS
  These results represent the first13C images of the human heart. The appearance of13C-bicarbonate signal after administration of hyperpolarized [1-13C]pyruvate was readily detected in this healthy cohort (n=4). This shows that assessment of pyruvate metabolism in vivo in humans is feasible using current technology.
  
  
  BACKGROUND
  URL: https://www.clinicaltrials.gov. Unique identifier: NCT02648009.
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C). chuck@sri.utoronto.ca.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Cunningham
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Justin Y C
authors.initials: JY
authors.lastname: Lau
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Albert P
authors.initials: AP
authors.lastname: Chen
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Geraghty
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: William J
authors.initials: WJ
authors.lastname: Perks
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Idan
authors.initials: I
authors.lastname: Roifman
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Graham A
authors.initials: GA
authors.lastname: Wright
authors.affiliation: From the Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); Medical Biophysics, University of Toronto, ON, Canada (C.H.C., J.Y.C.L., B.J.G., G.A.W.); GE Healthcare, Toronto, ON, Canada (A.P.C.); Pharmacy (W.J.P.) and Schulich Heart Program (I.R., G.A.W.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada (K.A.C).
authors.forename: Kim A
authors.initials: KA
authors.lastname: Connelly
mesh_terms: D000328:Adult; D002247:Carbon Isotopes; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D019289:Pyruvic Acid / Q000378:metabolism
chemical_list: D002247:Carbon Isotopes; D019289:Pyruvic Acid
keywords: heart failure; magnetic resonance imaging; metabolic imaging; metabolism; mitochondria