PMID- 9337189
OWN - NLM
STAT- MEDLINE
DCOM- 19971031
LR  - 20220321
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 96
IP  - 7
DP  - 1997 Oct 7
TI  - Myocardial phosphocreatine-to-ATP ratio is a predictor of mortality in patients 
      with dilated cardiomyopathy.
PG  - 2190-6
AB  - BACKGROUND: In patients with heart failure due to dilated cardiomyopathy, cardiac 
      energy metabolism is impaired, as indicated by a reduction of the myocardial 
      phosphocreatine-to-ATP ratio, measured noninvasively by 31P-MR spectroscopy. The 
      purpose of this study was to test whether the phosphocreatine-to-ATP ratio also 
      offers prognostic information in terms of mortality prediction as well as how 
      this index compares with well-known mortality predictors such as left ventricular 
      ejection fraction (LVEF) or New York Heart Association (NYHA) class. METHODS AND 
      RESULTS: Thirty-nine patients with dilated cardiomyopathy were followed up for 
      928+/-85 days (2.5 years). At study entry, LVEF and NYHA class were determined, 
      and the cardiac phosphocreatine-to-ATP ratio was measured by localized 31P-MR 
      spectroscopy of the anterior myocardium. During the study period, total mortality 
      was 26%. Patients were divided into two groups, one with a normal 
      phosphocreatine-to-ATP ratio (>1.60; mean+/-SE, 1.98+/-0.07; n=19; healthy 
      volunteers: 1.94+/-0.11, n=30) and one with a reduced phosphocreatine-to-ATP 
      ratio (<1.60; 1.30+/-0.05; n=20). At re-evaluation (mean, 2.5 years), 8 of 20 
      patients with reduced phosphocreatine-to-ATP ratios had died, all of 
      cardiovascular causes (total and cardiovascular mortality, 40%). Of the 19 
      patients with normal phosphocreatine-to-ATP ratios, 2 had died (total mortality, 
      11%), one of cardiovascular causes (cardiovascular mortality, 5%). Kaplan-Meier 
      analysis showed significantly reduced total (P=.036) and cardiovascular (P=.016) 
      mortality for patients with normal versus patients with low 
      phosphocreatine-to-ATP ratios. A Cox model for multivariate analysis showed that 
      the phosphocreatine-to-ATP ratio and NYHA class offered significant independent 
      prognostic information on cardiovascular mortality. CONCLUSIONS: The myocardial 
      phosphocreatine-to-ATP ratio, measured noninvasively with 31P-MR spectroscopy, is 
      a predictor of both total and cardiovascular mortality in patients with dilated 
      cardiomyopathy.
FAU - Neubauer, S
AU  - Neubauer S
AD  - Department of Medicine, Wurzburg University, Germany. 
      s.neubauer@rzbox.uni-wuerzburg.de
FAU - Horn, M
AU  - Horn M
FAU - Cramer, M
AU  - Cramer M
FAU - Harre, K
AU  - Harre K
FAU - Newell, J B
AU  - Newell JB
FAU - Peters, W
AU  - Peters W
FAU - Pabst, T
AU  - Pabst T
FAU - Ertl, G
AU  - Ertl G
FAU - Hahn, D
AU  - Hahn D
FAU - Ingwall, J S
AU  - Ingwall JS
FAU - Kochsiek, K
AU  - Kochsiek K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 020IUV4N33 (Phosphocreatine)
RN  - 27YLU75U4W (Phosphorus)
RN  - 8L70Q75FXE (Adenosine Triphosphate)
SB  - IM
MH  - Adenosine Triphosphate/analysis/*metabolism
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Dilated/*metabolism/*mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Life Tables
MH  - Magnetic Resonance Spectroscopy
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism
MH  - Phosphocreatine/analysis/*metabolism
MH  - Phosphorus
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Time Factors
EDAT- 1997/10/23 00:00
MHDA- 1997/10/23 00:01
CRDT- 1997/10/23 00:00
PHST- 1997/10/23 00:00 [pubmed]
PHST- 1997/10/23 00:01 [medline]
PHST- 1997/10/23 00:00 [entrez]
AID - 10.1161/01.cir.96.7.2190 [doi]
PST - ppublish
SO  - Circulation. 1997 Oct 7;96(7):2190-6. doi: 10.1161/01.cir.96.7.2190.