title: Brain metabolite alterations in Eisenmenger syndrome: Evaluation with MR proton spectroscopy.
abstract: OBJECTIVE
  Eisenmenger syndrome (ES) is a life-threatening disease characterized by pulmonary hypertension and cyanosis in patients with congenital heart diseases. The aim of this study was to determine the brain metabolite changes in Eisenmenger syndrome compared with a control group using MR proton spectroscopy.
  
  
  METHODS
  The study included 10 children (3 male, 7 female) with congenital heart diseases and a diagnosis of Eisenmenger syndrome. The control group consisted of 10 healthy volunteer children. All were examined with a 1.5T MRI scanner and single voxel spectroscopy was performed to obtain spectra from three different regions; left frontal subcortical white matter, left lentiform nucleus and left thalamus. Peak integral values obtained from the spectra were used as quantitative data.
  
  
  RESULTS
  The ages of the children with ES were between 5 and 16 years, and between 5 and 15 years in the control group. Periventricular white matter hyperintensities were observed in 3 patients. On MR spectroscopy study, significantly lower levels of Choline metabolite (Cho) were detected in the frontal subcortical region and thalamus regions of the patients compared with the control group. There was no statistically significant difference between the levels of other metabolites (NAA, Cr, mI and Glx). In the lentiform nucleus, although the average value of Cho in ES patients was lower than that of the control group, it was not statistically significant.
  
  
  CONCLUSIONS
  Cho metabolite was determined to have an important role in brain metabolism in Eisenmenger syndrome patients. Oral Cho treatment may help to extend survival.
authors.affiliation: Harran University School of Medicine, Department of Radiology, Sanliurfa, Turkey. Electronic address: dileksendokumaci@yahoo.com.
authors.forename: Dilek Şen
authors.initials: DŞ
authors.lastname: Dokumacı
authors.affiliation: Children Hospital, Department of Radiology, Sanliurfa, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Doğan
authors.affiliation: Children Hospital, Department of Pediatric Cardiology, Sanliurfa, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Yıldırım
authors.affiliation: Harran University School of Medicine, Department of Radiology, Sanliurfa, Turkey.
authors.forename: Fatıma Nurefşan
authors.initials: FN
authors.lastname: Boyacı
authors.affiliation: Harran University School of Medicine, Department of Radiology, Sanliurfa, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Bozdoğan
authors.affiliation: Harran University School of Medicine, Department of Pediatric Cardiology, Sanliurfa, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Koca
mesh_terms: D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives; D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004541:Eisenmenger Complex / Q000378:metabolism*; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism; D006801:Humans; D002534:Hypoxia, Brain / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D011522:Protons; D013788:Thalamus / Q000378:metabolism
chemical_list: D015415:Biomarkers; D011522:Protons; D001224:Aspartic Acid; D003401:Creatine; D002794:Choline
keywords: Choline; Chronic hypoxia; Eisenmenger syndrome; MR spectroscopy