Multiorgan, Multimodality Imaging in Cardiometabolic Disease

Abstract

Cardiometabolic disease, spanning conditions such as obesity to type 2 diabetes mellitus with excess cardiovascular risk, represents a major public health burden. Advances in preclinical translational science point to potential targets across multiple organ systems for early intervention to improve cardiometabolic health. Validation in clinical trials and translation to care would benefit from in vivo diagnostic techniques that facilitate therapeutic advancements. This review provides a state-of-the-art, multimodality perspective spanning the multiple organ systems that contribute to cardiometabolic disease.

Keywords: cardiovascular diseases; diabetes mellitus, type 2; humans; obesity; risk factors.

Figure

The cardiac consequences of cardiometabolic disease ensue from functional and structural alterations in multiple organ systems, including skeletal muscle, liver, the pancreas and microcirculation. Primary imaging targets for non-invasive investigation of CMD are listed. Multiple imaging modalities are used in the evaluation of organ systems involved in CMD. Skeletal muscle investigation typically involves multinuclear MR spectroscopy and MR imaging. Liver is non-invasively interrogated using CT, elastography (both MR and US) and PET for fat quantification, fibrosis quantification and glucose utilization, respectively. Pancreatic beta cell deficit is measured in humans using novel SPECT and PET techniques and in preclinical models with magnetic nanoparticles and MR imaging techniques. Adipose tissue can be quantified using MRI, CT, US and dual-energy x-ray absorptiometry. Brown adipose tissue can be quantified using FDG-PET techniques. Microcirculatory rarefaction and resistance can be evaluated with optical imaging techniques and PET. Finally, the heart in CMD can be investigated using US, MRI and multinuclear MR spectroscopy.