31P-MR Spectroscopy for the evaluation of energy metabolism in intact residual myocardium after acute myocardial infarction in humans
✍ Scribed by Beer, M
- Publisher
- Springer
- Year
- 2001
- Tongue
- English
- Weight
- 162 KB
- Volume
- 13
- Category
- Article
- ISSN
- 0968-5243
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✦ Synopsis
Objective: experimental studies have demonstrated that acute myocardial infarction (MI) alters energy metabolism even in non-infarcted adjacent tissue. In patients with subacute MI, the influence of the regional ischemic insult on energy metabolism of intact septal myocardium was analyzed using 31 P-Magnetic resonance spectroscopy (MRS).
Patients and Methods: in eight patients with wall motion abnormalities in the anterior wall 31 P-spectra were obtained from non-infarcted adjacent septal myocardium, as well as infarcted anterior myocardium (voxel size 25 ccm each) 29 9 8 days after MI using a 3D-CSI technique. Additionally, cardiac function was analyzed using breath-hold cine MRI. MRI was repeated 6 months after revascularization to assess viability of infarcted segments. Eight age-matched healthy volunteers served as control group.
Results: according to follow-up MRI 4/8 patients showed regional wall motion recovery. Here, PCr/ATP-ratios were not significantly reduced in intact septal myocardium as well as infarcted anterior myocardium compared to healthy volunteers (1.289 0.10 and 1.14 9 0.09 vs. 1.45 9 0.29). No recovery of regional function was detected in 4/8 patients with-therefore-nonviable anterior myocardium. PCr/ATP-ratios were significantly reduced in intact and infarcted myocardium compared with healthy volunteers as well as to patients with wall motion recovery (0.77 9 0.17 and 0.49 90.23; PB 0.05).
Discussion: these preliminary results indicate that energy metabolism is reduced in patients with persisting wall motion abnormalities after myocardial infarction and revascularization in ischemically injured as well as in adjacent non-injured myocardium.