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Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure
AIMS: Early detection of heart failure is important for timely treatment. During the development of heart failure, adaptive intracellular metabolic processes that evolve prior to macro-anatomic remodelling, could provide an early signal of impending failure. We hypothesized that metabolic imaging wi...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923679/ https://www.ncbi.nlm.nih.gov/pubmed/31329841 http://dx.doi.org/10.1093/ehjci/jez074 |
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author | Agger, Peter Hyldebrandt, Janus Adler Hansen, Esben Søvsø Szocska Omann, Camilla Bøgh, Nikolaj Waziri, Farhad Nielsen, Per Mose Laustsen, Christoffer |
author_facet | Agger, Peter Hyldebrandt, Janus Adler Hansen, Esben Søvsø Szocska Omann, Camilla Bøgh, Nikolaj Waziri, Farhad Nielsen, Per Mose Laustsen, Christoffer |
author_sort | Agger, Peter |
collection | PubMed |
description | AIMS: Early detection of heart failure is important for timely treatment. During the development of heart failure, adaptive intracellular metabolic processes that evolve prior to macro-anatomic remodelling, could provide an early signal of impending failure. We hypothesized that metabolic imaging with hyperpolarized magnetic resonance would detect the early development of heart failure before conventional echocardiography could reveal cardiac dysfunction. METHODS AND RESULTS: Five 8.5 kg piglets were subjected to pulmonary banding and subsequently examined by [1-(13)C]pyruvate hyperpolarization, conventional magnetic resonance imaging, echocardiography, and blood testing, every 4 weeks for 16 weeks. They were compared with a weight matched, healthy control group. Conductance catheter examination at the end of the study showed impaired right ventricular systolic function along with compromised left ventricular diastolic function. After 16 weeks, we saw a significant decrease in the conversion ratio of pyruvate/bicarbonate in the left ventricle from 0.13 (0.04) in controls to 0.07 (0.02) in animals with pulmonary banding, along with a significant increase in the lactate/bicarbonate ratio to 3.47 (1.57) compared with 1.34 (0.81) in controls. N-terminal pro-hormone of brain natriuretic peptide was increased by more than 300%, while cardiac index was reduced to 2.8 (0.95) L/min/m(2) compared with 3.9 (0.95) in controls. Echocardiography revealed no changes. CONCLUSION: Hyperpolarization detected a shift towards anaerobic metabolism in early stages of right ventricular dysfunction, as evident by an increased lactate/bicarbonate ratio. Dysfunction was confirmed with conductance catheter assessment, but could not be detected by echocardiography. Hyperpolarization has a promising future in clinical assessment of heart failure in both acquired and congenital heart disease. |
format | Online Article Text |
id | pubmed-6923679 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-69236792019-12-26 Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure Agger, Peter Hyldebrandt, Janus Adler Hansen, Esben Søvsø Szocska Omann, Camilla Bøgh, Nikolaj Waziri, Farhad Nielsen, Per Mose Laustsen, Christoffer Eur Heart J Cardiovasc Imaging Original Articles AIMS: Early detection of heart failure is important for timely treatment. During the development of heart failure, adaptive intracellular metabolic processes that evolve prior to macro-anatomic remodelling, could provide an early signal of impending failure. We hypothesized that metabolic imaging with hyperpolarized magnetic resonance would detect the early development of heart failure before conventional echocardiography could reveal cardiac dysfunction. METHODS AND RESULTS: Five 8.5 kg piglets were subjected to pulmonary banding and subsequently examined by [1-(13)C]pyruvate hyperpolarization, conventional magnetic resonance imaging, echocardiography, and blood testing, every 4 weeks for 16 weeks. They were compared with a weight matched, healthy control group. Conductance catheter examination at the end of the study showed impaired right ventricular systolic function along with compromised left ventricular diastolic function. After 16 weeks, we saw a significant decrease in the conversion ratio of pyruvate/bicarbonate in the left ventricle from 0.13 (0.04) in controls to 0.07 (0.02) in animals with pulmonary banding, along with a significant increase in the lactate/bicarbonate ratio to 3.47 (1.57) compared with 1.34 (0.81) in controls. N-terminal pro-hormone of brain natriuretic peptide was increased by more than 300%, while cardiac index was reduced to 2.8 (0.95) L/min/m(2) compared with 3.9 (0.95) in controls. Echocardiography revealed no changes. CONCLUSION: Hyperpolarization detected a shift towards anaerobic metabolism in early stages of right ventricular dysfunction, as evident by an increased lactate/bicarbonate ratio. Dysfunction was confirmed with conductance catheter assessment, but could not be detected by echocardiography. Hyperpolarization has a promising future in clinical assessment of heart failure in both acquired and congenital heart disease. Oxford University Press 2020-01 2019-04-27 /pmc/articles/PMC6923679/ /pubmed/31329841 http://dx.doi.org/10.1093/ehjci/jez074 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles Agger, Peter Hyldebrandt, Janus Adler Hansen, Esben Søvsø Szocska Omann, Camilla Bøgh, Nikolaj Waziri, Farhad Nielsen, Per Mose Laustsen, Christoffer Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title | Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title_full | Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title_fullStr | Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title_full_unstemmed | Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title_short | Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
title_sort | magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923679/ https://www.ncbi.nlm.nih.gov/pubmed/31329841 http://dx.doi.org/10.1093/ehjci/jez074 |
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