31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure.
BACKGROUND: The purpose of this work was to further define the value of cardiac 31P magnetic resonance (MR) spectroscopy for patients with coronary artery disease and dilated cardiomyopathy. METHODS AND RESULTS: Blood-corrected and T1-corrected 31P MR spectra of anteroseptal myocardium were obtained...
| Main Authors: | , , , , , , , , , |
|---|---|
| 格式: | Journal article |
| 语言: | English |
| 出版: |
1992
|
| _version_ | 1826286928005169152 |
|---|---|
| author | Neubauer, S Krahe, T Schindler, R Horn, M Hillenbrand, H Entzeroth, C Mader, H Kromer, E Riegger, G Lackner, K |
| author_facet | Neubauer, S Krahe, T Schindler, R Horn, M Hillenbrand, H Entzeroth, C Mader, H Kromer, E Riegger, G Lackner, K |
| author_sort | Neubauer, S |
| collection | OXFORD |
| description | BACKGROUND: The purpose of this work was to further define the value of cardiac 31P magnetic resonance (MR) spectroscopy for patients with coronary artery disease and dilated cardiomyopathy. METHODS AND RESULTS: Blood-corrected and T1-corrected 31P MR spectra of anteroseptal myocardium were obtained at rest using image-selected in vivo spectroscopy localization, a selected volume of 85 +/- 12 cm3, and a field strength of 1.5 T. Nineteen volunteers had a creatine phosphate (CP)/ATP ratio of 1.95 +/- 0.45 (mean +/- SD) and a PDE/ATP ratio of 1.06 +/- 0.53; in four patients with left anterior descending coronary artery (LAD) stenosis, six patients with chronic anterior wall infarction, and four patients with chronic posterior wall infarction, CP/ATP and phosphodiester (PDE)/ATP ratios did not differ from those in volunteers. Twenty-five measurements of 19 patients with dilated cardiomyopathy yielded a CP/ATP of 1.78 +/- 0.51 and a PDE/ATP of 0.98 +/- 0.56 (p = NS versus volunteers). When these patients were grouped according to the severity of heart failure, however, CP/ATP was 1.94 +/- 0.43 in mild (p = NS versus volunteers) and 1.44 +/- 0.52 in severe DCM (p < 0.05), respectively. No correlation was found between CP/ATP and left ventricular ejection fraction or fractional shortening, but correlation of CP/ATP with the New York Heart Association (NYHA) class was significant (r = 0.60, p < 0.005). Six patients with dilated cardiomyopathy were studied repeatedly before and after 12 +/- 6 weeks of drug treatment leading to clinical recompensation with improvement of the NYHA status by 0.8 +/- 0.3 classes. Concomitantly, CP/ATP increased from 1.51 +/- 0.32 to 2.15 +/- 0.27 (p < 0.01), whereas PDE/ATP did not change significantly. CONCLUSIONS: Cardiac high-energy phosphate metabolism at rest is normal in LAD stenosis and chronic myocardial infarction in the absence of heart failure. The CP/ATP ratio has low specificity for the diagnosis of dilated cardiomyopathy. However, CP/ATP correlated with the clinical severity of heart failure and may improve during clinical recompensation. |
| first_indexed | 2024-03-07T01:51:00Z |
| format | Journal article |
| id | oxford-uuid:9a1447c5-44f7-459a-84f3-055b434e8f81 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:51:00Z |
| publishDate | 1992 |
| record_format | dspace |
| spelling | oxford-uuid:9a1447c5-44f7-459a-84f3-055b434e8f812022-03-27T00:18:58Z31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9a1447c5-44f7-459a-84f3-055b434e8f81EnglishSymplectic Elements at Oxford1992Neubauer, SKrahe, TSchindler, RHorn, MHillenbrand, HEntzeroth, CMader, HKromer, ERiegger, GLackner, KBACKGROUND: The purpose of this work was to further define the value of cardiac 31P magnetic resonance (MR) spectroscopy for patients with coronary artery disease and dilated cardiomyopathy. METHODS AND RESULTS: Blood-corrected and T1-corrected 31P MR spectra of anteroseptal myocardium were obtained at rest using image-selected in vivo spectroscopy localization, a selected volume of 85 +/- 12 cm3, and a field strength of 1.5 T. Nineteen volunteers had a creatine phosphate (CP)/ATP ratio of 1.95 +/- 0.45 (mean +/- SD) and a PDE/ATP ratio of 1.06 +/- 0.53; in four patients with left anterior descending coronary artery (LAD) stenosis, six patients with chronic anterior wall infarction, and four patients with chronic posterior wall infarction, CP/ATP and phosphodiester (PDE)/ATP ratios did not differ from those in volunteers. Twenty-five measurements of 19 patients with dilated cardiomyopathy yielded a CP/ATP of 1.78 +/- 0.51 and a PDE/ATP of 0.98 +/- 0.56 (p = NS versus volunteers). When these patients were grouped according to the severity of heart failure, however, CP/ATP was 1.94 +/- 0.43 in mild (p = NS versus volunteers) and 1.44 +/- 0.52 in severe DCM (p < 0.05), respectively. No correlation was found between CP/ATP and left ventricular ejection fraction or fractional shortening, but correlation of CP/ATP with the New York Heart Association (NYHA) class was significant (r = 0.60, p < 0.005). Six patients with dilated cardiomyopathy were studied repeatedly before and after 12 +/- 6 weeks of drug treatment leading to clinical recompensation with improvement of the NYHA status by 0.8 +/- 0.3 classes. Concomitantly, CP/ATP increased from 1.51 +/- 0.32 to 2.15 +/- 0.27 (p < 0.01), whereas PDE/ATP did not change significantly. CONCLUSIONS: Cardiac high-energy phosphate metabolism at rest is normal in LAD stenosis and chronic myocardial infarction in the absence of heart failure. The CP/ATP ratio has low specificity for the diagnosis of dilated cardiomyopathy. However, CP/ATP correlated with the clinical severity of heart failure and may improve during clinical recompensation. |
| spellingShingle | Neubauer, S Krahe, T Schindler, R Horn, M Hillenbrand, H Entzeroth, C Mader, H Kromer, E Riegger, G Lackner, K 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title | 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title_full | 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title_fullStr | 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title_full_unstemmed | 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title_short | 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. |
| title_sort | 31p magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease altered cardiac high energy phosphate metabolism in heart failure |
| work_keys_str_mv | AT neubauers 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT krahet 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT schindlerr 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT hornm 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT hillenbrandh 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT entzerothc 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT maderh 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT kromere 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT rieggerg 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure AT lacknerk 31pmagneticresonancespectroscopyindilatedcardiomyopathyandcoronaryarterydiseasealteredcardiachighenergyphosphatemetabolisminheartfailure |