title: Assessment of myocardial creatine concentration in dysfunctional human heart by proton magnetic resonance spectroscopy.
abstract: Creatine depletion in the non-viable infarcted human heart was previously demonstrated with proton magnetic resonance (MR) spectroscopy (1H MRS). In the present study, we assessed total creatine (CR) in human hearts with non-ischemic dysfunctions such as cardiomyopathy. Using cardiac-gated 1H MRS with MR image-guided PRESS localization, we measured septal CR in healthy and diseased human hearts. Fifteen patients with chronic heart failure (CHF, left ventricular ejection fraction < 45%) and 14 age-matched normal subjects were examined. Myocardial CR was significantly (p < 0.001) lower in failing hearts (15.1+/-SD 5.0 micromol/g wet weight, range 8.0-22.9) than in normal hearts (27.6+/-4.1 micromol/g wet weight, range 20.8-36.2). Myocardial CR concentrations in six heart failure patients with plasma B-type natriuretic peptide (BNP) levels of > 200 pg/ml (11.5+/-0.9 micromol/g wet weight, range 9.9-12.3) were significantly lower than those in four heart failure patients with plasma BNP levels of < 200 pg/ml (19.8+/-2.5 micromol/g wet weight, range 17.7-22.9, p < 0.001). Thus, our study showed that myocardial CR was decreased in non-ischemic dysfunctional hearts. Noninvasive measurements of myocardial CR by 1H MRS may be useful in the assessment of the severity of heart failure.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, 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: Tetsuya
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Morikawa
authors.forename: Toshiro
authors.initials: T
authors.lastname: Inubushi
authors.forename: Terue
authors.initials: T
authors.lastname: Koh
authors.forename: Minoru
authors.initials: M
authors.lastname: Horie
mesh_terms: D003401:Creatine / Q000378:metabolism*; D005260:Female; D006331:Heart Diseases / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D019047:Phantoms, Imaging
chemical_list: D003401:Creatine