Proton magnetic resonance spectroscopy can detect creatine depletion associated with the progression of heart failure in cardiomyopathy

I Nakae, K Mitsunami, T Omura, T Yabe… - Journal of the American …, 2003 - jacc.org
I Nakae, K Mitsunami, T Omura, T Yabe, T Tsutamoto, S Matsuo, M Takahashi, S Morikawa…
Journal of the American College of Cardiology, 2003jacc.org
Objectives: This study noninvasively examined total creatine (CR) of the myocardium in
dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) using proton
magnetic resonance spectroscopy (1H-MRS). Background: Abnormalities in CR metabolism
in failing hearts have been reported. A biochemical study suggested that myocardial
metabolic changes are very similar in DCM and HCM despite the different heart failure (HF)
mechanisms. Methods: Using cardiac-gated 1H-MRS with magnetic resonance image (MRI) …
Objectives
This study noninvasively examined total creatine (CR) of the myocardium in dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) using proton magnetic resonance spectroscopy (1H-MRS).
Background
Abnormalities in CR metabolism in failing hearts have been reported. A biochemical study suggested that myocardial metabolic changes are very similar in DCM and HCM despite the different heart failure (HF) mechanisms.
Methods
Using cardiac-gated 1H-MRS with magnetic resonance image (MRI)-guided point-resolved spectroscopy (PRESS) localization, we quantitatively measured septal CR. Patients with either DCM (n = 11) or HCM (n = 7) and age-matched normal subjects (n = 14) were examined.
Results
Myocardial CR was significantly lower in DCM patients (16.1 ± 4.5 μmol/g wet weight [range 10.2 to 22.9], p < 0.05) than that in subjects with normal hearts (27.6 ± 4.1 μmol/g [range 21.4 to 36.2]). Myocardial CR in HCM patients (22.6 ± 8.1 μmol/g [range 12.2 to 34.5]) was significantly lower than that in subjects with normal hearts (p < 0.05) but was significantly higher than that in DCM patients (p < 0.05). In 18 patients with either DCM or HCM, myocardial CR correlated positively with left ventricular ejection fraction (LVEF) (y = 0.22x + 9.8, r = 0.73, p = 0.0006) but correlated negatively with plasma B-type natriuretic peptide (BNP) levels (y = −0.012x + 22.4, r = −0.54, p = 0.022).
Conclusions
This study showed that 1H-MRS can noninvasively detect CR depletion associated with the severity of HF in cardiomyopathy.
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