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Strategies for Imaging Metabolic Remodeling of the Heart in Obesity and Heart Failure

  • Nuclear Cardiology (V Dilsizian, Section Editor)
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Abstract

Purpose of Review

Define early myocardial metabolic changes among patients with obesity and heart failure, and to describe noninvasive methods and their applications for imaging cardiac metabolic remodeling.

Recent Findings

Metabolic remodeling precedes, triggers, and sustains functional and structural remodeling in the stressed heart. Alterations in cardiac metabolism can be assessed by using a variety of molecular probes. The glucose tracer analog, 18F-FDG, and the labeled tracer 11C-palmitate are still the most commonly used tracers to assess glucose and fatty acid metabolism, respectively. The development of new tracer analogs and imaging agents, including those targeting the peroxisome proliferator-activated receptor (PPAR), provides new opportunities for imaging metabolic activities at a molecular level. While the use of cardiac magnetic resonance spectroscopy in the clinical setting is limited to the assessment of intramyocardial and epicardial fat, new technical improvements are likely to increase its usage in the setting of heart failure.

Summary

Noninvasive imaging methods are an effective tool for the serial assessment of alterations in cardiac metabolism, either during disease progression, or in response to treatment.

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Acknowledgements

Work in the authors’ lab was supported by grants from the US Public Health Service (R01- HL-061483, R01- HL-073162). We thank Drs. Linda Peterson (Washington University St. Louis) and Raymond R. Russell (Alpert School of Medicine, Brown University). We also thank Mrs. Anna Menezes for expert editorial assistance.

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  1. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Amier Haidar

  2. Division of Cardiology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 1.220, Houston, TX, 77030, USA

    Heinrich Taegtmeyer

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Haidar, A., Taegtmeyer, H. Strategies for Imaging Metabolic Remodeling of the Heart in Obesity and Heart Failure. Curr Cardiol Rep 24, 327–335 (2022). https://doi.org/10.1007/s11886-022-01650-3

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