Contributions of 31P-magnetic resonance spectroscopy to the understanding of dilated heart muscle disease.
In the present work, we studied clinical and haemodynamic correlates of impaired cardiac high-energy phosphate metabolism in patients with heart failure due to dilated cardiomyopathy (DCM). Myocardial 31P-magnetic resonance (MR) spectra were obtained at 1.5 T in 14 volunteers and 23 patients with DCM (mean ejection fraction 34%) in order to quantify the creatine phosphate (CP)/ATP ratio. In addition, patients underwent cardiac catheterization and echocardiography. Compared to volunteers (2.02 +/- 0.11), CP/ATP ratios were significantly reduced in DCM patients (1.54 +/- 0.10; P < 0.05), indicating impaired high-energy phosphate metabolism. CP/ATP ratios correlated with the clinical severity of heart failure estimated from the NYHA class (r = 0.47, P < 0.01); also, CP/ATP correlated with left ventricular ejection fraction (r = 0.54, P < 0.01) and left ventricular end-diastolic wall thickness (r = 0.51, P < 0.01). Thus, 31P-MR spectroscopy can detect abnormal cardiac high-energy phosphate metabolism in patients with heart failure due to DCM. These abnormalities correlate with clinical and haemodynamic parameters. Future studies will have to determine whether 31P-MR spectroscopy can contribute to the routine clinical evaluation of patients with heart failure.
Neubauer
S
S
Department of Internal Medicine, Würzburg University, Germany.
Horn
M
M
Pabst
T
T
Gödde
M
M
Lübke
D
D
Jilling
B
B
Hahn
D
D
Ertl
G
G
D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010725:Phosphocreatine / Q000378:metabolism; D012016:Reference Values; D016277:Ventricular Function, Left / Q000502:physiology
D010725:Phosphocreatine; D000255:Adenosine Triphosphate