Patients on maintenance dialysis had a significantly lower myocardial PCr/beta-ATP ratio compared to healthy subjects (1.15 vs 1.63; P < 0.01).
Cross-Sectional (n=20)
Does Phosphorus-31 MR spectroscopy detect altered myocardial high energy phosphate metabolism in patients on maintenance dialysis compared to healthy subjects?
Phosphorus-31 MR spectroscopy can noninvasively detect decreased myocardial high energy phosphate metabolism (lower PCr/beta-ATP ratio) in patients on maintenance dialysis, particularly those with a history of heart failure.
Absolute Event Rate: 1.15% vs 1.63%
p-value: p=< 0.01
RATIONALE AND OBJECTIVES: Assessment of left ventricular metabolism and function is important in patients on maintenance dialysis because congestive heart failure occurs quite frequently and has a poor prognosis. The purpose of this study was to evaluate the changes of myocardial high energy metabolism in dialysis patients by using phosphorus-31 (31P) magnetic resonance (MR) spectroscopy. METHODS: Phosphorus-31 spectra were obtained from anteroseptal wall of the heart in six normal subjects (mean age, 24 +/- 1 years) and 14 dialysis patients (mean age, 52 +/- 11 years), using a 1.5-tesla clinical MR system. Four patients had previous history of heart failure. Echocardiography was performed in all patients to evaluate left ventricular (LV) hypertrophy and LV function. RESULTS: The averaged ratio of phosphocreatine (PCr)/beta-adenosine triphosphate (beta-ATP) in dialysis patients (1.15 +/- 0.25 mean +/- standard deviation), was significantly lower than that in healthy subjects (1.63 +/- 0.21; P < 0.01). There was no significant difference in PCr/beta-ATP ratios between the non-LV hypertrophy group (1.21 +/- 0.24; n = 7) and the LV hypertrophy group (1.09 +/- 0.24; n = 7). The averaged PCr/beta-ATP ratio in four patients with history of heart failure (0.96 +/- 0.18) was significantly lower than that of the 10 patients without history of heart failure (1.22 +/- 0.23; P < 0.05). CONCLUSIONS: These results indicate that patients on maintenance dialysis have decreased PCr/beta-ATP ratio and 31P MR spectroscopy can provide noninvasive assessment of altered high energy phosphate metabolism.
Tagami et al. (Sun,) conducted a cross-sectional in Maintenance dialysis (n=20). Maintenance dialysis vs. Healthy subjects was evaluated on Ratio of phosphocreatine (PCr)/beta-adenosine triphosphate (beta-ATP) (p=< 0.01). Patients on maintenance dialysis had a significantly lower myocardial PCr/beta-ATP ratio compared to healthy subjects (1.15 vs 1.63; P < 0.01).