Figure 4

Hyperpolarized [1-¹³C]pyruvate CMR showing alterations to pyruvate dehydrogenase complex (PDC) flux and [¹³C]lactate production with the pathogenesis of dilated cardiomyopathy (DCM). ( A ) Representative pyruvate (Pyr, top), bicarbonate (Bic, middle), and lactate (Lac, bottom) ¹³C CMR images taken from the same pig and at weekly intervals during the pacing protocol, until DCM developed. The images displayed for each metabolite were selected from the same, mid-papillary slice and in the same respiratory cycle. Signal intensity in the pyruvate image was scaled based on 15–100% of the maximum pyruvate signal at week 0, whereas the bicarbonate and lactate signal intensities were scaled based on 15–100% of the maximum bicarbonate signal intensity at week 0. ( B ) Relative changes to PDC flux with DCM in five pigs.(Reproduced with permission Eur J Heart Fail. 2013 February; 15(2): 130–140).