Slower recovery of muscle phosphocreatine in malignant hyperthermia-susceptible individuals assessed by 31P-MR spectroscopy |
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Authors: | K Monsieurs L Heytens Chantal Kloeck Jean-Jacques Martin Floris Wuyts Leo Bossaert |
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Institution: | (1) Department of Intensive Care, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium Tel.: +32-3-8213635 Fax: +32-3-8284882 e-mail: monsieur@uia.ua.ac.be, BE;(2) Department of Biomedical Physics, University of Antwerp (RUCA), Antwerp, Belgium, BE;(3) Department of Neurology, University Hospital Antwerp and Laboratory of Neuropathology, Born-Bunge Foundation, University of Antwerp (UIA), Edegem, Belgium, BE;(4) ENT Department, University Hospital Antwerp, Edegem, Belgium, BE |
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Abstract: | Our aim was to develop an exercise protocol using 31P-magnetic resonance spectroscopy (31P-MRS), which can discriminate between malignant hyperthermia-susceptible (MHS) individuals and controls. MRS spectra of the
forearm muscles were recorded at rest, during and after a standardized exercise protocol in 10 MHS patients and compared with
spectra obtained in 10 controls. There was no difference in resting intracellular pH (pHi) or PCr/ (Pi+PCr) ratio between
the groups (PCr = phosphocreatine, Pi = inorganic phosphorus). At the end of the exercise and during the initial recovery
phase, the pHi and PCr/(Pi+PCr) ratio were significantly lower in the MHS group (pHi: 6.37 (0.07) for MHS vs 6.70 (0.05)
for controls, P < 0.005; PCr/(Pi+PCr): 0.784 (0.017) for MHS vs 0.954 (0.020) for controls, P < 0.0005]). For PCr/ (Pi+PCr), complete separation between the two groups was observed during the initial recovery phase.
The mean recovery time of PCr/ (Pi+PCr) was 0.57 min for the control group and 1.28 min for the MHS group. The slower recovery
of PCr/ (Pi+PCr) is likely to be caused by a combination of several factors, including the lower pHi in MHS subjects at the
start of recovery (inhibiting ATP production) and excessive sarcoplasmic calcium overload (causing continued enzyme activation
and ATP consumption). Our exercise protocol can be a valuable adjunct to discriminate between MHS and non susceptible subjects.
Received: 10 July 1996 Received in revised form: 7 August 1997 Accepted: 11 August 1997 |
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Keywords: | Malignant hyperthermia Magnetic resonance spectroscopy non-invasive |
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