Myocardial creatine concentration in various nonischemic heart diseases assessed by 1H magnetic resonance spectroscopy
Myocardial creatine concentration in various nonischemic heart diseases assessed by 1H magnetic resonance spectroscopy
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DOI：
10.1253/circj.69.711
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发表时间：
2005-06-01
影响因子：
3.3
通讯作者：
Horie, M
中科院分区：
文献类型：
--
作者：
Nakae, I;Mitsunami, K;Horie, M
背景 先前的 P-31 磁共振波谱 (MRS) 研究表明，心肌磷酸肌酸与 ATP 的比率提供了有关心肌病患者功能障碍程度和预后的重要信息。在本研究中，我们使用 H-1 MRS 调查了各种患病心脏的总肌酸 (CR) 水平。方法和结果 对 14 名患有以下病症的患者进行了检查：心脏淀粉样变性 (n=2)；高血压性心脏病（4）；瓣膜病（2）；肥厚型心肌病 (2);扩张型心肌病 (2);限制性心肌病 (1);和术后房间隔缺损 (1)。使用具有点分辨光谱定位的 1H MRS 测量心肌 CR。总体而言，患病心脏的心肌 CR 水平显着低于对照组 [16.5 +/- 6.0 (n=14) vs 27.1 +/- 3.2 mu mol/g (n=10)，p < 0.001]。尽管心功能不全的机制不同，但心肌 CR 与左心室射血分数之间呈正相关（42.9 +/- 13.8%，范围 19.5-69.1%）（r=0.60，p < 0.05）。因心力衰竭住院1年内的患者心肌CR水平显着低于其他患者[11.3 +/- 1.0 (n=4) vs 18.6 +/- 5.9 mu mol/g (n=10), p < 0.05]。 结论 利用H-1 MRS无创测量心肌CR可能对评估各种形式心脏病的疾病严重程度和预测临床病程具有重要价值。
Background Previous P-31 magnetic resonance spectroscopy (MRS) studies demonstrated that the myocardial phosphocreatine-to-ATP ratio offered important information concerning the degree of dysfunction and prognosis in patients with cardiomyopathy. In the present study, we investigated total creatine (CR) levels in various diseased hearts using H-1 MRS.Methods and Results Fourteeen patients with the following conditions were examined: cardiac amyloidosis (n=2); hypertensive heart disease (4); valvular disease (2); hypertrophic cardiomyopathy (2); dilated cardiomyopathy (2); restrictive cardiomyopathy (1); and post-operative atrial septal defect (1). Myocardial CR was measured using 1H MRS with point-resolved spectroscopy localization. Overall, myocardial CR levels in diseased hearts were significantly lower than those in the control group [16.5 +/- 6.0 (n=14) vs 27.1 +/- 3.2 mu mol/g (n=10), p < 0.001]. There was a positive correlation between myocardial CR and left ventricular ejection fraction (42.9 +/- 13.8%, range 19.5-69.1%) despite the different mechanisms of cardiac dysfunction (r=0.60, p < 0.05). Myocardial CR levels in patients who were hospitalized due to heart failure within 1 year were significantly lower than those in other patients [11.3 +/- 1.0 (n=4) vs 18.6 +/- 5.9 mu mol/g (n=10), p < 0.05].Conclusions Noninvasive measurement of myocardial CR using H-1 MRS may be valuable in the assessment of disease severity and prediction of clinical course in various forms of heart disease.