(31)P-MR Spectroscopy for the evaluation of energy metabolism in intact residual myocardium after acute myocardial infarction in humans.
OBJECTIVE
Experimental studies have demonstrated that acute myocardial infarction (MI) alters energy metabolism even in non-infarcted adjacent tissue. In patients with subacute MI, the influence of the regional ischemic insult on energy metabolism of intact septal myocardium was analyzed using 31P-Magnetic resonance spectroscopy (MRS).


METHODS
In eight patients with wall motion abnormalities in the anterior wall 31P-spectra were obtained from non-infarcted adjacent septal myocardium, as well as infarcted anterior myocardium (voxel size 25 ccm each) 29+/-8 days after MI using a 3D-CSI technique. Additionally, cardiac function was analyzed using breath-hold cine MRI. MRI was repeated 6 months after revascularization to assess viability of infarcted segments. Eight age-matched healthy volunteers served as control group.


RESULTS
According to follow-up MRI 4/8 patients showed regional wall motion recovery. Here, PCr/ATP-ratios were not significantly reduced in intact septal myocardium as well as infarcted anterior myocardium compared to healthy volunteers (1.28+/-0.10 and 1.14+/-0.09 vs. 1.45+/-0.29). No recovery of regional function was detected in 4/8 patients with-therefore-non-viable anterior myocardium. PCr/ATP-ratios were significantly reduced in intact and infarcted myocardium compared with healthy volunteers as well as to patients with wall motion recovery (0.77+/-0.17 and 0.49+/-0.23; P<0.05).


CONCLUSIONS
These preliminary results indicate that energy metabolism is reduced in patients with persisting wall motion abnormalities after myocardial infarction and revascularization in ischemically injured as well as in adjacent non-injured myocardium.
Beer
M
M
Institut für Röntgendiagnostik, Universität Würzburg, Josef-Schneider-Strasse 2, 97080, Wurzburg, Germany. meinrad.beer@mail.uni-wuerzburg.de
Buchner
S
S
Sandstede
J
J
Viehrig
M
M
Lipke
C
C
Krug
A
A
Köstler
H
H
Pabst
T
T
Kenn
W
W
Landschütz
W
W
von Kienlin
M
M
Harre
K
K
Neubauer
S
S
Hahn
D
D
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000502:physiology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology*; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*