Metabolic Shifts in Myocardial Recovery Post-CABG Assessed by Hyperpolarized-13C MRI

Motivation: Coronary artery bypass grafting (CABG) is an effective treatment for severe coronary artery disease, yet its effects on effects on myocardial metabolic response remain poorly characterized. Goal(s): To investigate post-CABG metabolic recovery by evaluating real-time pyruvate metabolism in CAD patients. Approach: Hyperpolarized carbon-13 MRI (HP-13C MRI) was used to assess pre- and post-CABG myocardial metabolism in four CAD patients, comparing results with healthy controls to monitor pyruvate oxidation and metabolic recovery. Results: Results indicate substantial variability in post-surgical metabolic recovery. While most patients displayed reduced pyruvate oxidation, one patient showed an improved bic/(bic+lac) ratio, suggesting diverse recovery pathways possibly influenced by substrate selection. Impact: HP-13C MRI could guide personalized postoperative care, providing targeted metabolic insights that support optimized CAD patient management.