Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure Determinaciones de niveles de creatina y lípidos mediante espectroscopia por resonancia magnética en miocardio de pacientes con insuficiencia cardiaca no isquémica

Winter J.L.; Castro P. ; Chalhub M.; Verdejo H.; greig d.; Gabrielli, L; Hernandez C.; Uribe, S.; Meneses L.; Chiong M.; Lavandero S.; Concepcion, R; Mellado R.

Keywords: chemistry, spectroscopy, muscle, water, heart, lipids, stroke, volume, physiology, metabolism, humans, resonance, human, male, failure, nuclear, aged, pathophysiology, female, control, article, myocardium, lipid, case-control, magnetic, studies, study, creatine, middle, case


Background: Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/ creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites. Aim: To measure myocardial creatine and lipids by MR spectroscopy among patients with HF. Material and Methods: Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in five patients with non-ischemic heart failure, aged 58 ± 9.7 years, (60% males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained. Results: Among patients, left ventricular ejection fraction was 32 ± 6.9%, 60% were in functional capacity II, 60% had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/ Cr index, among patients with heart failure, when compared with healthy controls (1.46 ± 1.21 and 5.96 ± 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 ± 2.66 and 1.80 ± 1.62 respectively, p = 0.08). Conclusions: Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy.

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Título de la Revista: REVISTA MEDICA DE CHILE
Volumen: 138
Número: 12
Editorial: Sociedad Médica de Santiago
Fecha de publicación: 2010
Página de inicio: 1475
Página final: 1479