Detection of abnormal calf muscle metabolism in patients with heart failure using phosphorus-31 nuclear magnetic resonance.
Detection of abnormal calf muscle metabolism in patients with heart failure using phosphorus-31 nuclear magnetic resonance.
复制标题
利用磷31核磁共振检测心力衰竭患者小腿肌肉代谢异常。
DOI：
10.1016/0002-9149(88)90266-4
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Wilson,JR
中科院分区：
文献类型：
--
作者：
Mancini,DM;Ferraro,N;Tuchler,M;Chance,B;Wilson,JR
心力衰竭患者经常报告运动时腿部疲劳。然而，目前还没有客观的方法来检测这些患者的腿部肌肉异常。为了确定磷-31核磁共振波谱是否能提供这样的信息，该技术被用于比较20例心力衰竭患者（峰值氧耗量（VO 2）为13.6±5 ml/kg/min，射血分数20±5%）和9名年龄匹配的正常受试者的小腿爬楼梯和跖屈反应。通过测量VO 2来量化工作。在静息状态下，两组显示出相似的无机磷与磷酸肌酸（P1 PCr）比值（心力衰竭患者0.21±0.07，正常受试者0.21±0.06，差异不显著）和pH水平（心力衰竭患者7.06±0.17，正常受试者7.05±0.11，差异不显著）。在正常受试者和心力衰竭患者中，随着VO 2的增加，运动导致P1 PCr逐渐上升。然而，检查VO 2与P1 PCr的关系显示，心力衰竭患者在爬楼梯和跖屈时的斜率更陡。在正常受试者中，两种运动形式都没有降低小腿pH值。心力衰竭患者在跖屈最高工作水平时pH值显著降低（心力衰竭患者pH值为6.86±0.20，正常人pH值为7.07±0.14，P< 0.01）。心力衰竭患者的代谢恢复时间也比正常人延长（分别为3.3±0.8和2.1±0.5分钟，p< 0.002）。这些发现表明，磷-31核磁共振提供了心力衰竭患者腿部肌肉异常的客观证据。
Patients with heart failure frequently report leg fatigue during exercise. At present, however, there is no objective method of detecting leg muscle abnormalities in such patients. To determine if phosphorus-31 nuclear magnetic resonance spectroscopy can provide such information, this technique was used to compare calf responses to stair climbing and plantarflexion in 20 patients with heart failure (peak oxygen consumption (VO 2) of 13.6±5 ml/kg/min, ejection fraction 20±5%) and 9 agematched normal subjects. Work was quantified by measuring VO 2. At rest, both groups exhibited similar inorganic phosphorus to phosphocreatine (P 1 PCr) ratios (patients with heart failure 0.21±0.07, normal subjects 0.21±0.06, difference not significant) and pH levels (patients with heart failure 7.06±0.17, normal subjects 7.05±0.11, difference not significant). In both normal subjects and patients with heart failure, exercise resulted in a progressive rise in P 1 PCr as VO 2 increased. However, examination of the relation of VO 2 versus P 1 PCr revealed steeper slopes in patients with heart failure during both stair climbing and plantarflexion. Neither form of exercise decreased calf pH in normal subjects. In the patients with heart failure, significant decreases in pH were noted during the highest work level of plantarflexion (pH of heart failure patients 6.86±0.20, pH of normal subjects 7.07±0.14, p< 0.01). Metabolic recovery time was also prolonged in the patients with heart failure versus normal subjects (3.3±0.8 vs 2.1±0.5 minutes, respectively, p< 0.002). These findings indicate that phosphorus-31 nuclear magnetic resonance provides objective evidence of leg muscle abnormalities in patients with heart failure.