Zurich researchers help revolutionize heart imaging 'to see what’s really going on in the heart muscle and its cells'

Researchers from the University of Zurich and ETH Zurich have achieved a major breakthrough in medical imaging technology by developing a method that allows for the visualization of metabolic processes in the body using magnetic resonance imaging (MRI).

This pioneering approach, discussed in a University of Zurich news release, has the potential to revolutionize the diagnosis and treatment of heart disease by enabling real-time imaging of metabolism, particularly in the complex case of the heart.

“For us physicians, it’s very valuable to map the metabolism of the heart. In the future, this could enable us to improve diagnoses and prognoses of heart disease – and thus to tailor treatment more closely to the individual,” Professor Robert Manka, director of cardiac MRI at the Heart Center of UniversityHospital Zurich, said in the release. "In the future, we’ll be able to see what’s really going on in the heart muscle and its cells.”

Magnetic resonance imaging (MRI) has transformed the field of medical imaging, providing valuable insights into the structure and function of organs and tissues. However, traditional MRI techniques have limitations when it comes to mapping changes in metabolism, which play a crucial role in many diseases, including heart conditions. To overcome this challenge, Professor Sebastian Kozerke and his team from the Institute for Biomedical Engineering at ETH Zurich and the University of Zurich have pushed the boundaries of MRI technology.

The researchers focused their efforts on visualizing the metabolism of the heart, which is particularly intricate due to its ability to utilize multiple energy sources. One of the main obstacles they faced was capturing the constantly moving heart and the low concentrations of metabolic molecules. However, they overcame these challenges by utilizing hyperpolarized MRI, a technique that amplifies the signal of metabolic molecules by more than 25,000 times.

The team developed a specialized device, nicknamed the "fridge," which operates alongside a clinical MRI machine. The fridge uses hyperpolarized MRI to enhance the signal strength of a sugar intermediate called pyruvate. Pyruvate is deep-frozen at an extremely low temperature before being magnetized in a magnetic field with the aid of microwaves. Once warmed back to body temperature, the pyruvate can be used for imaging, similar to conventional contrast agents. This innovative method allows for non-invasive and real-time visualization of how the heart metabolizes nutrients and converts them into usable energy, providing insights into the heart's energy sources.

According to the University of Zurich, this groundbreaking development holds significant potential, particularly in the field of heart disease. Changes in metabolism can serve as early indicators of a heart condition. By detecting and imaging these metabolic processes, physicians could identify oxygen deficiencies at an early stage, enabling targeted treatments to address the underlying causes of cardiovascular diseases.

The effectiveness of the method has already been demonstrated in a study led by Maximilian Fuetterer and published in the "Journal of the American College of Cardiology: Cardiovascular Imaging." The researchers collaborated with the Center for Surgical Research at the University of Zurich and used pigs as a model to map metabolic changes following a heart attack. Pigs have hearts that closely resemble human hearts, allowing for detailed analysis.

The next step for the researchers is to conduct a clinical trial in collaboration with Manka. The trial will involve examining patients with heart failure or risk factors for heart failure. By mapping the metabolism of the heart, physicians can improve diagnoses and prognoses of heart disease. This innovative MRI method could pave the way for precision medicine, tailoring treatments more closely to each individual's condition.

While further refinement and larger-scale clinical studies are necessary, the researchers are optimistic about the potential of their prototype fridge technology. It has the capability to offer unprecedented insights into the intricate workings of the heart and its cells, potentially revolutionizing the diagnosis and treatment of heart disease and leading to improved patient outcomes.