title: Alteration of energy production by the heart in CRF patients undergoing peritoneal dialysis.
abstract: Cardiovascular disease is commonly observed in patients with chronic renal failure and this is a leading cause of death in patients with end-stage renal disease undergoing maintenance dialysis. Myocardial energy production is a very crucial aspect of cardiac function. Therefore, to evaluate energy metabolism of myocardial muscle in peritoneal dialysis (PD) patients, we carried out the following study using Magnetic resonance spectroscopy (MRS). Fourteen chronic renal failure patients and eight healthy volunteers were enrolled. The ratio of the phosphocreatine peak to the beta-phosphate to ATP peak (PCr/beta-ATP) was calculated from their MR spectra obtained by 31P-MR spectroscopy (Gyroscan S15, Philips). To determine the correlation between cardiac function and energy status, the left atrial diameter, the left ventricular (LV) end-diastolic diameter, the ejection fraction, the fraction of shortening and the LV mass index were measured by echocardiography. Peripheral blood sampling was also performed for creatinine, blood urea nitrogen, hematocrit, hemoglobin, beta2-microglobuline, intact parathyroid hormone. PCr/beta-ATP was significantly lower in PD (1.03 +/- 0.15 vs. 1.40 +/- 0.18: p = 0.0002), although all patients showed normal systolic function. No correlation was found between PCr/beta-ATP and cardiac function or hematological or biochemical markers. A negative correlation was present between PCr/beta-ATP and dialysis duration (r = 0.57, p < 0.05). Altered energy status of the myocardium in PD should be considered even if the patients did not show any systolic dysfunction. 31P-MRS is a useful tool to evaluate the energy status of the myocardium.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. g2ogi@marianna-u.ac.jp
authors.forename: Goichi
authors.initials: G
authors.lastname: Ogimoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sakurada
authors.forename: Keiko
authors.initials: K
authors.lastname: Imamura
authors.forename: Shingo
authors.initials: S
authors.lastname: Kuboshima
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Maeba
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Owada
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010530:Peritoneal Dialysis; D010761:Phosphorus Radioisotopes; D013997:Time Factors
chemical_list: D010761:Phosphorus Radioisotopes; D000255:Adenosine Triphosphate