title: Energetic differences between viable and non-viable myocardium in patients with recent myocardial infarction are not an effect of differences in wall thinning- a multivoxel (31)P-MR-spectroscopy and MRI study.
abstract: To evaluate multivoxel (31)P-MR spectroscopy (MRS) for assessment of energy metabolism in patients with myocardial infarction (MI) in correlation to left ventricular (LV) wall thickness and the outcome of revascularization. Thirty patients with subacute anterior myocardial infarction and planned revascularization were enrolled. 3D-chemical shift imaging was applied to determine PCr/ATP ratios in two areas: infarcted/anterior and noninfarcted/septal myocardium. MRI was used to evaluate LV function and wall thickness, and was repeated 6 months after revascularization to assess myocardial viability. Fifteen volunteers were controls. Fifteen patients showed normalization of wall motion abnormalities after revascularization (Group 1; viable), 15 not (Group 2; non-viable). Regarding infarcted/anterior myocardium, Group 2 had lower PCr/ATP ratios (0.81 +/- 0.60 vs 1.17 +/- 0.25), and PCr/ATP ratios were reduced in both groups compared to controls (1.45 +/- 0.29). Regarding noninfarcted/septal myocardium, again Group 2 had lower ratios (0.93 +/- 0.53 vs 1.31 +/- 0.38); however, compared to controls (1.51 +/- 0.32) a reduction of PCr/ATP ratios was only found in Group 2. For both myocardial regions, no correlations between PCr/ATP ratios and LV wall thickness were detected. The more severe energetic alteration in irreversibly damaged myocardium is not an effect of differences of wall thinning. Additional alterations of noninfarcted, adjacent myocardium can be detected.
authors.affiliation: Institut für Röntgendiagnostik, Universität Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany. beer@roentgen.uni-wuerzburg.de
authors.forename: Meinrad
authors.initials: M
authors.lastname: Beer
authors.forename: Wolfram
authors.initials: W
authors.lastname: Machann
authors.forename: Jörn
authors.initials: J
authors.lastname: Sandstede
authors.forename: Stefan
authors.initials: S
authors.lastname: Buchner
authors.forename: Claudia
authors.initials: C
authors.lastname: Lipke
authors.forename: Herbert
authors.initials: H
authors.lastname: Köstler
authors.forename: Reinhard
authors.initials: R
authors.lastname: Lorenz
authors.forename: Kerstin
authors.initials: K
authors.lastname: Harre
authors.forename: Matthias
authors.initials: M
authors.lastname: Spindler
authors.forename: Dietbert
authors.initials: D
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004562:Electrocardiography; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000628:therapy; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D010759:Phosphorus Isotopes; D018709:Statistics, Nonparametric; D020257:Ventricular Remodeling
chemical_list: D010759:Phosphorus Isotopes