title: (31)P magnetic resonance spectroscopy to measure in vivo cardiac energetics in normal myocardium and hypertrophic cardiomyopathy: Experiences at 3T.
abstract: BACKGROUND
  (31)P magnetic resonance spectroscopy (MRS) allows measurement of in vivo high-energy phosphate kinetics in the myocardium. While traditionally (31)P cardiac spectroscopy is performed at 1.5T, cardiac MRS at higher field strength can theoretically increase signal to noise ratio (SNR) and spectral resolution therefore improving sensitivity and specificity of the cardiac spectra. The reproducibility and feasibility of performing cardiac spectroscopy at 3T is presented here in this study in healthy volunteers and patients with hypertrophic cardiomyopathy.
  
  
  METHODS
  Cardiac spectroscopy was performed using a Phillips 3T Achieva scanner in 37 healthy volunteers and 26 patients with hypertrophic cardiomyopathy (HCM) to test the feasibility of the protocol. To test the reproducibility a single volunteer was scanned eight times on separate occasions. A single voxel (31)P MRS was performed using Image Selected In vivo Spectroscopy (ISIS) volume localization.
  
  
  RESULTS
  The mean phosphocreatine/adenosine triphosphate (PCr/ATP) ratio of the eight measurements performed on one individual was 2.11+/-0.25. Bland Altman plots showed a variance of 12% in the measurement of PCr/ATP ratios. The PCr/ATP ratio was significantly reduced in HCM patients compared to controls, 1.42+/-0.51 and 2.11+/-0.57, respectively, P<0.0001. (All results are expressed as mean+/-standard deviation).
  
  
  CONCLUSIONS
  Here we demonstrate that cardiac (31)P MRS at 3T is a reliable method of measuring in vivo high-energy phosphate kinetics in the myocardium for clinical studies and diagnostics. Based on our data an impairment of cardiac energetic state in patients with hypertrophic cardiomyopathy is indisputable.
authors.affiliation: Department of Cardiovascular Medicine, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK. drgani23@gmail.com
authors.forename: Ganesh Nallur
authors.initials: GN
authors.lastname: Shivu
authors.forename: Khalid
authors.initials: K
authors.lastname: Abozguia
authors.forename: Thanh Trung
authors.initials: TT
authors.lastname: Phan
authors.forename: Ibrar
authors.initials: I
authors.lastname: Ahmed
authors.forename: Anke
authors.initials: A
authors.lastname: Henning
authors.forename: Michael
authors.initials: M
authors.lastname: Frenneaux
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010710:Phosphates / Q000378:metabolism*; D010759:Phosphorus Isotopes / Q000032:analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D010710:Phosphates; D010759:Phosphorus Isotopes