title: [Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure].
abstract: BACKGROUND
  Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites.
  
  
  OBJECTIVE
  To measure myocardial creatine and lipids by MR spectroscopy among patients with HF.
  
  
  METHODS
  Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in five patients with non-ischemic heart failure, aged 58 ± 9.7 years, (60% males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained.
  
  
  RESULTS
  Among patients, left ventricular ejection fraction was 32 ± 6.9%, 60% were in functional capacity II, 60% had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/ Cr index, among patients with heart failure, when compared with healthy controls (1.46 ± 1.21 and 5.96 ± 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 ± 2.66 and 1.80 ± 1.62 respectively, p = 0.08).
  
  
  CONCLUSIONS
  Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy.
authors.affiliation: Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Winter
authors.forename: Pablo
authors.initials: P
authors.lastname: Castro
authors.forename: Luis
authors.initials: L
authors.lastname: Meneses
authors.forename: Mónica
authors.initials: M
authors.lastname: Chalhub
authors.forename: Hugo
authors.initials: H
authors.lastname: Verdejo
authors.forename: Douglas
authors.initials: D
authors.lastname: Greig
authors.forename: Luigi
authors.initials: L
authors.lastname: Gabrielli
authors.forename: Mario
authors.initials: M
authors.lastname: Chiong
authors.forename: Roberto
authors.initials: R
authors.lastname: Concepción
authors.forename: Rosemerie
authors.initials: R
authors.lastname: Mellado
authors.forename: Claudia
authors.initials: C
authors.lastname: Hernández
authors.forename: Sergio
authors.initials: S
authors.lastname: Uribe
authors.forename: Sergio
authors.initials: S
authors.lastname: Lavandero
mesh_terms: D016022:Case-Control Studies; D003401:Creatine / Q000032:analysis*; D005260:Female; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008055:Lipids / Q000032:analysis*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry*; D013318:Stroke Volume / Q000502:physiology; D014867:Water / Q000737:chemistry
chemical_list: D008055:Lipids; D014867:Water; D003401:Creatine