Prognostic Value of Hyperpolarized 13C MRI for Clinical Myocardial Viability

PRIMARY OBJECTIVES: The principal aim of this investigation is to employ noninvasive techniques for the in vivo assessment of segmental myocardial metabolism. This will be achieved by measuring the hyperpolarized (HP) 13C bicarbonate-to-lactate (bic/lac) ratio in patients scheduled for coronary artery bypass surgery (CABG), both preoperatively and 4-6 months postoperatively. These findings will be compared with a control group of healthy subjects to establish normal metabolic values. SECONDARY OBJECTIVES: In addition to the primary objectives, this study seeks to accomplish the following secondary objectives: 1. To ascertain the safety profile and tolerability of HP \[1-13C\] pyruvate administration during the MRI exam. 2. To evaluate the reproducibility of the HP 13C MRI data if the optional second injection of hyperpolarized 13C pyruvate is administered. EXPLORATORY OBJECTIVES: In pursuit of further insights, this research also aims to explore the following: 1. Investigate potential associations between blood measurements for pyruvate, triglycerides, free fatty acids, and insulin levels with the bicarbonate/lactate ratio within the myocardium. 2. Explore correlations between segmental myocardial metabolism (the bic/lac ratio) and mechanical function, such as echocardiographic measurements of wall motion.