title: Imaging porcine cardiac substrate selection modulations by glucose, insulin and potassium intervention: A hyperpolarized [1-13C]pyruvate study.
abstract: Cardiac metabolism has received considerable attention in terms of both diagnostics and prognostics, as well as a novel target for treatment. As human trials involving hyperpolarized magnetic resonance in the heart are imminent, we sought to evaluate the general feasibility of detection of an imposed shift in metabolic substrate utilization during metabolic modulation with glucose-insulin-potassium (GIK) infusion, and thus the limitations associated with this strategy, in a large animal model resembling human physiology. Four [1-13C]pyruvate injections did not alter the blood pressure or ejection fraction over 180 min. Hyperpolarized [1-13C]pyruvate conversion showed a generally high reproducibility, with intraclass correlation coefficients between the baseline measurements at 0 and 30 min as follows: lactate to pyruvate, 0.85; alanine to pyruvate, 1.00; bicarbonate to pyruvate, 0.83. This study demonstrates that hyperpolarized [1-13C]pyruvate imaging is a feasible technique for cardiac studies and shows a generally high reproducibility in fasted large animals. GIK infusion increases the metabolic conversion of pyruvate to its metabolic derivatives lactate, alanine and bicarbonate, but with increased variability.
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.|Danish Diabetes Academy, Odense, Denmark.
authors.forename: Esben Søvsø Szocska
authors.initials: ESS
authors.lastname: Hansen
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.|Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark.
authors.forename: Rasmus Stilling
authors.initials: RS
authors.lastname: Tougaard
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Thomas Stokholm
authors.initials: TS
authors.lastname: Nørlinger
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Emmeli
authors.initials: E
authors.lastname: Mikkelsen
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Per Mose
authors.initials: PM
authors.lastname: Nielsen
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Lotte Bonde
authors.initials: LB
authors.lastname: Bertelsen
authors.affiliation: Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Hans Stødkilde
authors.initials: HS
authors.lastname: Jørgensen
authors.affiliation: MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Christoffer
authors.identifier: http://orcid.org/0000-0002-0317-2911
authors.initials: C
authors.lastname: Laustsen
mesh_terms: D000409:Alanine / Q000378:metabolism; D000818:Animals; D001639:Bicarbonates / Q000378:metabolism; D002247:Carbon Isotopes / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D021621:Imaging, Three-Dimensional; D007328:Insulin / Q000378:metabolism*; D019344:Lactic Acid / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008991:Monitoring, Physiologic; D011188:Potassium / Q000378:metabolism*; D019289:Pyruvic Acid / Q000378:metabolism*; D034421:Sus scrofa
chemical_list: D001639:Bicarbonates; D002247:Carbon Isotopes; D007328:Insulin; D019344:Lactic Acid; D019289:Pyruvic Acid; D005947:Glucose; D000409:Alanine; D011188:Potassium
keywords: GIK; MRI; cardiac; hyperpolarization