title: [Cardiac energy metabolism in heart valve diseases with 31P MR spectroscopy].
abstract: OBJECTIVE
  Heart valve disease combined with left ventricular hypertrophy leads to derangements in cardiac energy metabolism, which can be detected non-invasively by 31P-MR-spectroscopy. The purpose of the present study was to examine whether the derangements in cardiac metabolism are reversible after surgical valve replacement.
  
  
  METHODS
  10 healthy volunteers and 10 patients with aortic stenosis (pressure gradients > 60 mmHg) were included. For assessment of energy metabolism, 31P-MR spectra were obtained with a double oblique 3D-CSI technique (voxel size 25 cm3). In 5 of 10 patients, follow-up examination was performed 3 months after surgical valve replacement (SVR). Left ventricular (LV) function was analyzed by cine MRI.
  
  
  RESULTS
  Before SVR the myocardial phosphocreatine to adenosinetriphosphate (PCr-ATP) ratio was significantly (p = 0.0002) reduced to 0.80 +/- 0.25 in patients compared to 1.65 +/- 0.21 in volunteers. 3 months after SVR, LV mass had significantly (p = 0.04) decreased from 238 +/- 33 g to 206 +/- 47 g. At the same time a significant (p = 0.04) increase of the PCr-ATP ratio from 0.80 +/- 0.25 to 1.28 +/- 0.22 was observed. A slight, but not significant, reduction of the phosphodiester ATP ratio was observed before SVR, with a trend towards normalization after SVR.
  
  
  CONCLUSIONS
  After SVR, the deranged energy metabolism shows a trend towards normalization. Further follow-up is necessary to determine whether complete normalization of the energetic derangement can be observed over longer periods of time following SVR.
authors.affiliation: Institut für Röntgendiagnostik, Universität Würzburg. meinrad.beer@mail.uni-wuerzburg.de
authors.forename: M
authors.initials: M
authors.lastname: Beer
authors.forename: M
authors.initials: M
authors.lastname: Viehrig
authors.forename: T
authors.initials: T
authors.lastname: Seyfarth
authors.forename: J
authors.initials: J
authors.lastname: Sandstede
authors.forename: C
authors.initials: C
authors.lastname: Lipke
authors.forename: T
authors.initials: T
authors.lastname: Pabst
authors.forename: W
authors.initials: W
authors.lastname: Kenn
authors.forename: K
authors.initials: K
authors.lastname: Harre
authors.forename: M
authors.initials: M
authors.lastname: Horn
authors.forename: W
authors.initials: W
authors.lastname: Landschütz
authors.forename: M
authors.initials: M
authors.lastname: von Kienlin
authors.forename: S
authors.initials: S
authors.lastname: Neubauer
authors.forename: D
authors.initials: D
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010710:Phosphates / Q000378:metabolism*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D012016:Reference Values; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D010710:Phosphates