Altered energy metabolism after myocardial infarction assessed by 31P-MR-spectroscopy in humans |
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Authors: | M Beer J Sandstede W Landschütz M Viehrig K Harre M Horn M Meininger T Pabst W Kenn A Haase M von Kienlin S Neubauer D Hahn |
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Institution: | Institut für R?ntgendiagnostik, Universit?t Würzburg, Josef-Schneider-Strasse 2, D-97080 Würzburg, Germany, DE Physikalisches Institut EP V, Universit?t Würzburg, Josef-Schneider-Strasse 2, D-97080 Würzburg, Germany, DE Medizinische Klinik, Universit?t Würzburg, Josef-Schneider-Strasse 2, D-97080 Würzburg, Germany, DE
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Abstract: | The value of 31P-magnetic resonance spectroscopy (MRS) as a possible tool to distinguish viable from non-viable tissue after myocardial infarction
was analysed in humans. Fifteen patients 3 weeks after anterior myocardial infarction were studied with breath-hold cine MRI
and 3D-CSI MRS (1.5 T system). 31P-spectra were obtained from infarcted as well as non-infarcted myocardium (voxel size 25 cm3 each). Gold standard for viability was recovery of regional function, as determined by a control MRI 6 months after revascularization.
Ten age-matched healthy volunteers served as control group. No significant difference was found between the phosphocreatine
to adenosinetriphosphate (PCr/ATP) ratio of volunteers (SD 1.72 ± 0.31) and non-infarcted septal myocardium of patients. Cine
MRI demonstrated recovery of regional function in 10 patients, i. e. 10 patients showed viable and 5 non-viable myocardium.
In viable myocardium, the PCr/ATP ratio was 1.47 ± 0.38 (non-significant vs volunteers; p > 0.05). In the 5 patients with akinetic myocardium, PCr peaks could not be detected. Therefore, calculation of PCr/ATP ratios
was not possible. However, a significant reduction of the ATP signal-to-noise ratio (SNR) was observed (2.92 ± 0.73 vs 6.68
± 0.80; patients vs volunteers; p <0.05). The SNR of ATP of akinetic regions may predict recovery of function after revascularization in patients with myocardial
infarction.
Received: 9 September 1999; Revised: 30 November 1999; Accepted: 24 December 1999 |
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Keywords: | : Heart Ischaemia MR imaging MR spectroscopy High-energy phosphates |
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