Targeted Metabolic Imaging to Improve the Management of Heart Disease

Osterholt, Moritz; Sen, Shiraj; Dilsizian, Vasken; Taegtmeyer, Heinrich

doi:10.1016/j.jcmg.2011.11.009

Cited by 25 publications

(9 citation statements)

References 80 publications

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“…These techniques will make it possible to assess coronary flow, myocardial perfusion, oxygen delivery, metabolism, and contraction simultaneously (24). …”

Section: Challenges Of Right Ventricular Imagingmentioning

confidence: 99%

“…New imaging options using tracer techniques are emerging and will give an opportunity for the simultaneous assessment of cardiac performance at different levels in vivo . These techniques will make it possible to assess coronary flow, myocardial perfusion, oxygen delivery, metabolism, and contraction simultaneously ( 24 ).…”

Section: Challenges Of Right Ventricular Imagingmentioning

confidence: 99%

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Right Ventricular Failure and Pathobiology in Patients with Congenital Heart Disease – Implications for Long-Term Follow-Up

et al. 2013

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Right ventricular dysfunction represents a common problem in patients with congenital heart defects, such as Tetralogy of Fallot or pulmonary arterial hypertension. Patients with congenital heart defects may present with a pressure or volume overloaded right ventricle (RV) in a bi-ventricular heart or in a single ventricular circulation in which the RV serves as systemic ventricle. Both subsets of patients are at risk of developing right ventricular failure. Obtaining functional and morphological imaging data of the right heart is technically more difficult than imaging of the left ventricle. In contrast to findings on mechanisms of left ventricular dysfunction, very little is known about the pathophysiologic alterations of the right heart. The two main causes of right ventricular dysfunction are pressure and/or volume overload of the RV. Until now, there are no appropriate models available analyzing the effects of pressure and/or volume overload on the RV. This review intends to summarize clinical aspects mainly focusing on the current research in this field. In future, there will be increasing attention to individual care of patients with right heart diseases. Hence, further investigations are essential for understanding the right ventricular pathobiology.

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“…These techniques will make it possible to assess coronary flow, myocardial perfusion, oxygen delivery, metabolism, and contraction simultaneously (24). …”

Section: Challenges Of Right Ventricular Imagingmentioning

confidence: 99%

Section: Challenges Of Right Ventricular Imagingmentioning

confidence: 99%

Right Ventricular Failure and Pathobiology in Patients with Congenital Heart Disease – Implications for Long-Term Follow-Up

et al. 2013

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“…1 As a complex clinical syndrome, HF is associated with ventricular desynchrony and energy system abnormalities. [2][3][4] Cardiac resynchronization therapy (CRT) is an efficient treatment for patients with drug-refractory HF, which enables an improvement in both heart function and quality of life and prolongs survival time. [5][6][7][8][9] Although some patients meet with the latest criteria for implantation, in fact, up to 30% of them may not benefit from CRT.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive plasma metabolites profiling reveals phosphatidylcholine species as potential predictors for cardiac resynchronization therapy response

Yang

Zhao

et al. 2020

ESC Heart Failure

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Aims This study aimed to identify the plasma metabolite fingerprint in patients with heart failure and to develop a prediction tool based on differential metabolites for predicting the response to cardiac resynchronization therapy (CRT). Methods and results We prospectively recruited 32 healthy individuals and 42 consecutive patients with HF who underwent CRT between January 2018 and January 2019. Peripheral venous blood samples, clinical data, and echocardiographic signatures were collected before CRT implantation. Liquid chromatography‐mass spectrometry was used to perform untargeted metabolites profiling for peripheral plasma under ESI+ and ESI− modes. After 6 month follow‐up, patients were categorized as CRT responders or non‐responders based on the alterations of echocardiographic characteristics. Compared with healthy individuals, patients with HF had distinct metabolomic profiles under both ESI+ and ESI− modes, featuring increased free fatty acids, carnitine, β‐hydroxybutyrate, and dysregulated lipids with heterogeneous alterations such as phosphatidylcholines (PCs) and sphingomyelins. Disparities of baseline metabolomics profile were observed between CRT responders and non‐responders under ESI+ mode but not under ESI− mode. Further metabolites analysis revealed that a group of 20 PCs metabolites under ESI+ mode were major contributors to the distinct profiles between the two groups. We utilized LASSO regression model and identified a panel of four PCs metabolites [including PC (20:0/18:4), PC (20:4/20:0), PC 40:4, and PC (20:4/18:0)] as major predictors for CRT response prediction. Among our whole population (n = 42), receive operating characteristics analysis revealed that the four PCs‐based model could nicely discriminate the CRT responders from non‐responders (area under the curve = 0.906) with a sensitivity of 83.3% and a specificity of 90.0%. Cross‐validation analysis also showed a satisfactory and robust performance of the model with the area under the curve of 0.910 in the training dataset and 0.880 in the testing dataset. Conclusions Patients with HF held significantly altered plasma metabolomics profile compared with the healthy individuals. Within the HF group, the non‐responders had a distinct plasma metabolomics profile in contrast to the responders to CRT, which was characterized by increased PCs species. A novel predictive model incorporating four PCs metabolites performed well in identifying CRT non‐responders. These four PCs might severe as potential biomarkers for predicting CRT response. Further validations are needed in multi‐centre studies with larger external cohorts.

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“…According to Randle cycle, in the presence of both substrates, between 60 to 90% of oxygen is consumed to oxidize fatty acids. 105 Both substrates are absorbed to the cytosol trough specific transporters and, after internalization, are metabolized and these metabolic intermediates are transported into the inner mitochondrial membrane to supply the Krebs cycle for the production of NADH, FADH 2 and GTP. These reducing equivalents are then used by the electron transport chain for the production of ATP.…”

Section: Cardiac Metabolism Imagingmentioning

confidence: 99%

The Potential of Metabolic Imaging

Gialleonardo

Wilson

Keshari

2016

Seminars in Nuclear Medicine

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Metabolic imaging is a field of molecular imaging that focuses and targets changes in metabolic pathways for the evaluation of different clinical conditions. Targeting and quantifying metabolic changes non-invasively is a powerful approach to facilitate diagnosis and evaluate therapeutic response. This review addresses only techniques targeting metabolic pathways. Other molecular imaging strategies, such as affinity/receptor imaging or microenvironment-dependent methods are beyond the scope of this review. Here we describe the current state of the art in clinically translatable metabolic imaging modalities. Specifically, we will focus on positron emission tomography (PET) and magnetic resonance spectroscopy (MRS), including conventional 1H and 13C MRS at thermal equilibrium and hyperpolarized magnetic resonance imaging (HP MRI). In this paper, we first provide an overview of metabolic pathways that are altered in many pathological conditions and the corresponding probes and techniques used to study those alterations. We will then describe the application of metabolic imaging to several common diseases including cancer, neurodegeneration, cardiac ischemia, and infection/inflammation.

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Targeted Metabolic Imaging to Improve the Management of Heart Disease

Cited by 25 publications

References 80 publications

Right Ventricular Failure and Pathobiology in Patients with Congenital Heart Disease – Implications for Long-Term Follow-Up

Right Ventricular Failure and Pathobiology in Patients with Congenital Heart Disease – Implications for Long-Term Follow-Up

Comprehensive plasma metabolites profiling reveals phosphatidylcholine species as potential predictors for cardiac resynchronization therapy response

The Potential of Metabolic Imaging

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