{"doi":"10.1101/2023.10.16.23297052","title":"Regional quantification of cardiac metabolism with hyperpolarized [1 - <sup>13</sup> C]-pyruvate MRI evaluated in an oral glucose challenge","abstract":"Abstract Background The heart has metabolic flexibility, which is influenced by fed/fasting states, and pathologies such as myocardial ischemia and hypertrophic cardiomyopathy (HCM). Hyperpolarized (HP) 13 C-pyruvate MRI is a promising new tool for non-invasive quantification of myocardial glycolytic and Krebs cycle flux. However, human studies of HP 13 C-MRI have yet to demonstrate regional quantification of metabolism, which is important in regional ischemia and HCM patients with asymmetric septal/apical hypertrophy. Methods We developed and applied methods for whole-heart imaging of 13 C-pyruvate, 13 C-lactate and 13 C-bicarbonate, following intravenous administration of [1- 13 C]-pyruvate. The image acquisition used an autonomous scanning method including bolus tracking, real-time magnetic field calibrations and metabolite-specific imaging. For quantification of metabolism, we evaluated 13 C metabolite images, ratio metrics, and pharmacokinetic modeling to provide measurements of myocardial lactate dehydrogenase (LDH) and pyruvate dehydrogenase (PDH) mediated metabolic conversion in 5 healthy volunteers (fasting &amp; 30 min following oral glucose load). Results We demonstrate whole heart coverage for dynamic measurement of pyruvate-to-lactate conversion via LDH and pyruvate-to-bicarbonate conversion via PDH at a resolution of 6×6×21 mm 3 ( 13 C-pyruvate) and 12×12×21 mm 3 ( 13 C-lactate, 13 C-bicarbonate). 13 C-pyruvate and 13 C-lactate were detected simultaneously in the RV blood pool, immediately after intravenous injection, reflecting LDH activity in blood. In healthy volunteers, myocardial 13 C-pyruvate-SNR, 13 C-lactate-SNR, 13 C-bicarbonate-SNR, 13 C-lactate/pyruvate ratio, 13 C-pyruvate-to-lactate conversion rate, k PL , and 13 C-pyruvate-to-bicarbonate conversion rate, k PB , all had statistically significant increases following oral glucose challenge. k PB , reflecting PDH activity and pyruvate entering the Krebs Cycle, had the highest correlation with blood glucose levels and was statistically significant. Conclusions We demonstrate first-in-human regional quantifications of cardiac metabolism by HP 13 C-pyruvate MRI that aims to reflect LDH and PDH activity.","journal":"medRxiv","year":2023,"id":401232,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9628,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":422376,"name":"Shuyu Tang","orcid":"0000-0002-9911-482X","position":1,"is_corresponding":false},{"id":884982,"name":"Xiaoxi Liu","orcid":"0000-0003-0657-8922","position":2,"is_corresponding":false},{"id":1084942,"name":"Avantika Sinha","orcid":"0000-0002-9349-6345","position":3,"is_corresponding":false},{"id":387685,"name":"Nicholas Dwork","orcid":"0000-0002-9838-4772","position":4,"is_corresponding":false},{"id":1084943,"name":"Sanjay Sivalokanathan","orcid":"0000-0002-3227-3295","position":5,"is_corresponding":false},{"id":462038,"name":"Jing Liu","orcid":"0000-0003-4740-243X","position":6,"is_corresponding":false},{"id":345505,"name":"Robert Bok","orcid":"0000-0003-1737-9056","position":7,"is_corresponding":false},{"id":700913,"name":"Karen Ordovás","orcid":"0000-0001-5438-4669","position":8,"is_corresponding":false},{"id":247805,"name":"James Slater","orcid":"0000-0003-3888-0317","position":9,"is_corresponding":false},{"id":345502,"name":"Jeremy W. Gordon","orcid":"0000-0003-2760-4886","position":10,"is_corresponding":false},{"id":458353,"name":"M. Roselle Abraham","orcid":"0000-0002-7989-2210","position":11,"is_corresponding":false},{"id":313995,"name":"Peder E. Z. Larson","orcid":"0000-0003-4183-3634","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T01:20:08.195423Z","pmid":"37904936","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}