title: Myocardial triglyceride content at 3 T cardiovascular magnetic resonance and left ventricular systolic function: a cross-sectional study in patients hospitalized with acute heart failure.
abstract: BACKGROUND
  Increased myocardial triglyceride (TG) content has been recognized as a risk factor for cardiovascular disease. However, its relation with cardiac function in patients on recovery from acute heart failure (HF) remains unclear. In this cross-sectional study, we sought to investigate the association between myocardial TG content measured on magnetic resonance spectroscopy ((1)H-MRS) and left ventricular (LV) function assessed on cardiovascular magnetic resonance (CMR) in patients who were hospitalized with HF.
  
  
  METHODS
  A total of 50 patients who were discharged after hospitalization for acute HF and 21 age- and sex-matched controls were included in the study. Myocardial TG content and LV parameters (function and mass) were measured on a 3.0 T MR scanner. Fatty acid (FA) and unsaturated fatty acid (UFA) content was normalized against water (W) using the LC-Model algorithm. The patient population was dichotomized according to the left ventricular ejection fraction (LVEF, <50% or ≥ 50%).
  
  
  RESULTS
  H-MRS data were available for 48 patients and 21 controls. Of the 48 patients, 25 had a LVEF <50% (mean, 31.2%), whereas the remaining 23 had a normal LVEF (mean, 60.2%). Myocardial UFA/W ratio was found to differ significantly in patients with low LVEF, normal LVEF, and controls (0.79% vs. 0.21% vs. 0.14%, respectively, p = 0.02). The myocardial UFA/TG ratio was associated with LV mass (r = 0.39, p < 0.001) and modestly related to LV end-diastolic volume (LVEDV; r = 0.24, p = 0.039). We also identified negative correlations of the myocardial FA/TG ratio with both LV mass (r = -0.39, p < 0.001) and LVEDV (r = -0.24, p = 0.039).
  
  
  CONCLUSIONS
  As compared with controls, patients who were discharged after hospitalization for acute HF had increased myocardial UFA content; furthermore, UFA was inversely related with LVEF, LV mass and, to a lesser extent, LVEDV. Our study may stimulate further research on the measure of myocardial UFA content by (1)H-MRS for outcome prediction.
  
  
  BACKGROUND
  ClinicalTrial.gov: NCT02378402 . Registered 27/02/2015.
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. wakefield1006@gmail.com.
authors: Pen-An
authors: PA
authors: Liao
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. giginlin@gmail.com.|Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan. giginlin@gmail.com.
authors: Gigin
authors: G
authors: Lin
authors: Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan. syytsai@gmail.com.
authors: Shang-Yueh
authors: SY
authors: Tsai
authors: Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung, Taiwan. bearty54@gmail.com.
authors: Chao-Hung
authors: CH
authors: Wang
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. Jonat126@yahoo.com.tw.
authors: Yu-Hsiang
authors: YH
authors: Juan
authors: Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan. yuching1221@adm.cgmh.org.tw.
authors: Yu-Ching
authors: YC
authors: Lin
authors: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. wu.mingting@gmail.com.
authors: Ming-Ting
authors: MT
authors: Wu
authors: Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. lyyang0111@gmail.com.
authors: Lan-Yan
authors: LY
authors: Yang
authors: Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung, Taiwan. minimin624@gmail.com.
authors: Min-Hui
authors: MH
authors: Liu
authors: Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan. jeanietc@cgmh.org.tw.
authors: Tsun-Ching
authors: TC
authors: Chang
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. jack805@gmail.com.
authors: Yu-Chun
authors: YC
authors: Lin
authors: Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan. 8702022@adm.cgmh.org.tw.
authors: Yu-Chieh
authors: YC
authors: Huang
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. spookie@adm.cgmh.org.tw.
authors: Pei-Ching
authors: PC
authors: Huang
authors: Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan. jwang@mail.cgu.edu.tw.
authors: Jiun-Jie
authors: JJ
authors: Wang
authors: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan. shuhangng@gmail.com.
authors: Shu-Hang
authors: SH
authors: Ng
authors: Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan. ngkk@ms.14.hinet.net.
authors: Koon-Kwan
authors: KK
authors: Ng
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005231:Fatty Acids, Unsaturated / Q000032:analysis; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry*; D011237:Predictive Value of Tests; D011379:Prognosis; D066244:Proton Magnetic Resonance Spectroscopy; D013318:Stroke Volume; D013599:Systole; D014280:Triglycerides / Q000032:analysis*; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D005231:Fatty Acids, Unsaturated; D014280:Triglycerides