Imaging Myocardial Metabolism

Abstract

Metabolism of exogenous and endogenous substrates, under baseline conditions and in response to metabolic and physiological stimuli, is central to cardiac myocyte health. The ever-burgeoning body of evidence demonstrating the primacy of perturbations in intermediary metabolism in the pathogenesis of common cardiovascular diseases such as ischemic heart disease, heart failure, and diabetic cardiomyopathy further supports this contention. It is becoming increasingly apparent that chronic adaptations in cellular metabolism initiates a host of pleiotropic actions detrimental to cellular health such as impaired energetics, increases in inflammation, oxidative stress, and apoptosis [1, 2]. Our understanding of metabolic pathways continues to evolve with the acquisition of vast quantities of information from metabolomics, proteomics, and transcriptomics that are integrated from “big-data” sets such as the Kyoto Encyclopedia of Genes and Genomes [3]. The importance of myocardial metabolism was highlighted in a recent scientific statement from the American Heart Association [4]. Finally, interest in modifying intermediary metabolism underlying human cardiovascular disease is exemplified by the robust drug discovery and development efforts to identify new metabolic modulators [5].