title: Myocardial creatine concentration in various nonischemic heart diseases assessed by 1H magnetic resonance spectroscopy.
abstract: BACKGROUND
  Previous (31)P magnetic resonance spectroscopy (MRS) studies demonstrated that the myocardial phosphocreatine-to-ATP ratio offered important information concerning the degree of dysfunction and prognosis in patients with cardiomyopathy. In the present study, we investigated total creatine (CR) levels in various diseased hearts using 1H MRS.
  
  
  RESULTS
  Fourteen patients with the following conditions were examined: cardiac amyloidosis (n = 2); hypertensive heart disease (4); valvular disease (2); hypertrophic cardiomyopathy (2); dilated cardiomyopathy (2); restrictive cardiomyopathy (1); and post-operative atrial septal defect (1). Myocardial CR was measured using 1H MRS with point-resolved spectroscopy localization. Overall, myocardial CR levels in diseased hearts were significantly lower than those in the control group [16.5+/-6.0 (n = 14) vs 27.1+/-3.2 micromol/g (n = 10), p < 0.001]. There was a positive correlation between myocardial CR and left ventricular ejection fraction (42.9+/-13.8%, range 19.5-69.1%) despite the different mechanisms of cardiac dysfunction (r = 0.60, p < 0.05). Myocardial CR levels in patients who were hospitalized due to heart failure within 1 year were significantly lower than those in other patients [11.3+/-1.0 (n = 4) vs 18.6+/-5.9 micromol/g (n = 10), p < 0.05].
  
  
  CONCLUSIONS
  Noninvasive measurement of myocardial CR using 1H MRS may be valuable in the assessment of disease severity and prediction of clinical course in various forms of heart disease.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakae
authors.forename: Kenichi
authors.initials: K
authors.lastname: Mitsunami
authors.forename: Shinro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Toshiro
authors.initials: T
authors.lastname: Inubushi
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Morikawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsutamoto
authors.forename: Terue
authors.initials: T
authors.lastname: Koh
authors.forename: Minoru
authors.initials: M
authors.lastname: Horie
mesh_terms: D000328:Adult; D000368:Aged; D003401:Creatine / Q000032:analysis*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011859:Radiography
chemical_list: D003401:Creatine