(31)P-MR Spectroscopy for the evaluation of energy metabolism in intact residual myocardium after acute myocardial infarction in humans

• Published in: Magma (New York, N.Y.) Vol. 13; no. 2; pp. 70 - 75
• Main Authors: Beer, M, Buchner, S, Sandstede, J, Viehrig, M, Lipke, C, Krug, A, Köstler, H, Pabst, T, Kenn, W, Landschütz, W, von Kienlin, M, Harre, K, Neubauer, S, Hahn, D
• Format: Journal Article
• Language: English
• Published: Germany 01.10.2001
• Subjects: Aged; Case-Control Studies; Female; Heart - physiology; Humans; Magnetic Resonance Spectroscopy - methods; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - pathology; Myocardium - metabolism; Myocardium - pathology
• ISSN: 0968-5243
• DOI: 10.1016/S1352-8661(01)00130-2

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 31P-Magnetic resonance spectroscopy (MRS). In eight patients with wall motion abnormalities in the anterior wall 31P-spectra were obtained from non-infarcted adjacent septal myocardium, as well as infarcted anterior myocardium (voxel size 25 ccm each) 29+/-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. 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 (1.28+/-0.10 and 1.14+/-0.09 vs. 1.45+/-0.29). No recovery of regional function was detected in 4/8 patients with-therefore-non-viable 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+/-0.17 and 0.49+/-0.23; P<0.05). 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.