Investigation of exercise-induced skeletal muscle energy metabolism in patients with cirrhosis using dynamic 31P-MRS on a clinical MRI system

Motivation: As liver function declines, energy stores in the liver is compensated by muscle, resulting in muscle mass loss and, ultimately, sarcopenia. 31P-MRS derived metabolic parameters may allow deeper understanding of muscle energy metabolism in patients with cirrhosis. Goal(s): Our goal was to compare exercise-induced skeletal muscle energy metabolism between healthy volunteers and cirrhotic patients. Approach: Dynamic 31P-MRS with exercise challenge was conducted in regular clinical setting and metabolic parameters were evaluated. Results: Patients with higher Child-Pugh score showed higher Pi/PCr ratio, which may suggest impaired energy metabolism in the muscles of cirrhotic patients prior to the onset of sarcopenia. Impact: Metabolic parameters derived from dynamic 31P−MRS in clinical setting showed a different trend in patients with cirrhosis compared to those of healthy volunteers. It may be possible to early identify cirrhotic patients at risk of developing sarcopenia.