PMID- 1451253
OWN - NLM
STAT- MEDLINE
DCOM- 19930104
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 86
IP  - 6
DP  - 1992 Dec
TI  - 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery 
      disease. Altered cardiac high-energy phosphate metabolism in heart failure.
PG  - 1810-8
AB  - 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.
FAU - Neubauer, S
AU  - Neubauer S
AD  - Department of Medicine, Wurzburg University, FRG.
FAU - Krahe, T
AU  - Krahe T
FAU - Schindler, R
AU  - Schindler R
FAU - Horn, M
AU  - Horn M
FAU - Hillenbrand, H
AU  - Hillenbrand H
FAU - Entzeroth, C
AU  - Entzeroth C
FAU - Mader, H
AU  - Mader H
FAU - Kromer, E P
AU  - Kromer EP
FAU - Riegger, G A
AU  - Riegger GA
FAU - Lackner, K
AU  - Lackner K
AU  - et al.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Phosphates)
RN  - 27YLU75U4W (Phosphorus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Output, Low/*metabolism
MH  - Cardiomyopathy, Dilated/*diagnosis/metabolism
MH  - Coronary Disease/*diagnosis/metabolism
MH  - *Energy Metabolism
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/metabolism/pathology
MH  - Phosphates/metabolism
MH  - *Phosphorus
MH  - Reference Values
EDAT- 1992/12/01 00:00
MHDA- 1992/12/01 00:01
CRDT- 1992/12/01 00:00
PHST- 1992/12/01 00:00 [pubmed]
PHST- 1992/12/01 00:01 [medline]
PHST- 1992/12/01 00:00 [entrez]
AID - 10.1161/01.cir.86.6.1810 [doi]
PST - ppublish
SO  - Circulation. 1992 Dec;86(6):1810-8. doi: 10.1161/01.cir.86.6.1810.