PMID- 9394098
OWN - NLM
STAT- MEDLINE
DCOM- 19971229
LR  - 20151119
IS  - 1081-5589 (Print)
IS  - 1081-5589 (Linking)
VI  - 45
IP  - 8
DP  - 1997 Oct
TI  - Cardiac high-energy phosphate metabolism in patients with aortic valve disease 
      assessed by 31P-magnetic resonance spectroscopy.
PG  - 453-62
AB  - BACKGROUND: The purpose of this work was to determine the clinical and 
      hemodynamic correlates of alterations in cardiac high-energy phosphate metabolism 
      in patients with aortic stenosis and with aortic incompetence. METHODS: Fourteen 
      volunteers, 13 patients with aortic stenosis, and 9 patients with aortic 
      incompetence were included. Patients underwent echocardiography and left and 
      right heart catheterization. 31P-MR spectra from the anterior myocardium were 
      obtained with a 1.5 Tesla clinical MR system. RESULTS: Aortic stenosis and aortic 
      incompetence patients had similar New York Heart Association (NYHA) classes (2.77 
      +/- 0.12 vs 2.44 +/- 0.18), ejection fractions (normal), left ventricular (LV) 
      end-diastolic pressures, and LV wall thickness. In volunteers, 
      phosphocreatine/adenosine triphosphate (ATP) ratios were 2.02 +/- 0.11. For all 
      patients, phosphocreatine/ATP was significantly reduced (1.64 +/- 0.09; *p = 
      0.011 vs volunteers). Phosphocreatine/ATP decreased to 1.55 +/- 0.12 (*p = 0.008) 
      in aortic stenosis, while in aortic incompetence, phosphocreatine/ATP only showed 
      a trend for a reduction (1.77 +/- 0.12; p = 0.148). For all patients, 
      phosphocreatine/ATP decreased significantly only with NYHA class III (1.51 +/- 
      0.09; *p = 0.001), but not with NYHA classes I and II (phosphocreatine/ATP 1.86 
      +/- 0.18). In aortic stenosis, phosphocreatine/ATP ratios decreased (1.13 +/- 
      0.03; *p = 0.019) only when LV end-diastolic pressures were > 15 mm Hg or when LV 
      diastolic wall stress was > 20 kdyne cm-2 (1.13 +/- 0.03; *p = 0.024). 
      CONCLUSIONS: For a similar clinical degree of heart failure in human myocardium, 
      volume overload hypertrophy does not, but pressure overload does, induce 
      significant impairment of cardiac high-energy phosphate metabolism. In aortic 
      valve disease, alterations of high-energy phosphate metabolism are related to the 
      degree of heart failure.
FAU - Neubauer, S
AU  - Neubauer S
AD  - Department of Medicine, Wurzburg University, Germany.
FAU - Horn, M
AU  - Horn M
FAU - Pabst, T
AU  - Pabst T
FAU - Harre, K
AU  - Harre K
FAU - Stromer, H
AU  - Stromer H
FAU - Bertsch, G
AU  - Bertsch G
FAU - Sandstede, J
AU  - Sandstede J
FAU - Ertl, G
AU  - Ertl G
FAU - Hahn, D
AU  - Hahn D
FAU - Kochsiek, K
AU  - Kochsiek K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Investig Med
JT  - Journal of investigative medicine : the official publication of the American 
      Federation for Clinical Research
JID - 9501229
RN  - 0 (Phosphates)
RN  - 0 (Phosphorus Radioisotopes)
RN  - 020IUV4N33 (Phosphocreatine)
RN  - 8L70Q75FXE (Adenosine Triphosphate)
SB  - IM
MH  - Adenosine Triphosphate/metabolism
MH  - Adult
MH  - Aged
MH  - Aortic Valve Insufficiency/etiology/*metabolism/pathology
MH  - Aortic Valve Stenosis/etiology/*metabolism/pathology
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Magnetic Resonance Spectroscopy
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism/pathology
MH  - Phosphates/*metabolism
MH  - Phosphocreatine/metabolism
MH  - Phosphorus Radioisotopes
EDAT- 1997/12/12 00:00
MHDA- 1997/12/12 00:01
CRDT- 1997/12/12 00:00
PHST- 1997/12/12 00:00 [pubmed]
PHST- 1997/12/12 00:01 [medline]
PHST- 1997/12/12 00:00 [entrez]
PST - ppublish
SO  - J Investig Med. 1997 Oct;45(8):453-62.