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31P magnetic resonance spectroscopy to measure in vivo cardiac energetics in normal myocardium and hypertrophic cardiomyopathy: Experiences at 3 T

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Nallur Shivu, G., Abozguia, K., Phan, T., Ahmed, I., Henning, A., & Frenneaux, M. (2010). 31P magnetic resonance spectroscopy to measure in vivo cardiac energetics in normal myocardium and hypertrophic cardiomyopathy: Experiences at 3 T. European Journal of Radiology, 73(2), 255-259. doi:10.1016/j.ejrad.2008.10.018.


Cite as: http://hdl.handle.net/11858/00-001M-0000-0013-C120-6
Abstract
Background 31P magnetic resonance spectroscopy (MRS) allows measurement of in vivo high-energy phosphate kinetics in the myocardium. While traditionally 31P cardiac spectroscopy is performed at 1.5 T, cardiac MRS at higher field strength can theoretically increase signal to noise ratio (SNR) and spectral resolution therefore improving sensitivity and specificity of the cardiac spectra. The reproducibility and feasibility of performing cardiac spectroscopy at 3 T is presented here in this study in healthy volunteers and patients with hypertrophic cardiomyopathy. Methods Cardiac spectroscopy was performed using a Phillips 3T Achieva scanner in 37 healthy volunteers and 26 patients with hypertrophic cardiomyopathy (HCM) to test the feasibility of the protocol. To test the reproducibility a single volunteer was scanned eight times on separate occasions. A single voxel 31P MRS was performed using Image Selected In vivo Spectroscopy (ISIS) volume localization. Results The mean phosphocreatine/adenosine triphosphate (PCr/ATP) ratio of the eight measurements performed on one individual was 2.11 ± 0.25. Bland Altman plots showed a variance of 12 in the measurement of PCr/ATP ratios. The PCr/ATP ratio was significantly reduced in HCM patients compared to controls, 1.42 ± 0.51 and 2.11 ± 0.57, respectively, P < 0.0001. (All results are expressed as mean ± standard deviation). Conclusions Here we demonstrate that cardiac 31P MRS at 3 T is a reliable method of measuring in vivo high-energy phosphate kinetics in the myocardium for clinical studies and diagnostics. Based on our data an impairment of cardiac energetic state in patients with hypertrophic cardiomyopathy is indisputable.