Myocardial Creatine Concentration in Various Nonischemic Heart Diseases Assessed by 1H Magnetic Resonance Spectroscopy

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  • Nakae Ichiro
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Mitsunami Kenichi
    Department of General Medicine, Shiga University of Medical Science
  • Matsuo Shinro
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Inubushi Toshiro
    Molecular Neuroscience Research Center, Shiga University of Medical Science
  • Morikawa Shigehiro
    Molecular Neuroscience Research Center, Shiga University of Medical Science
  • Tsutamoto Takayoshi
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Koh Terue
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Horie Minoru
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

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Abstract

Background Previous 31P magnetic resonance spectroscopy (MRS) studies demonstrated that the myocardial phosphocreatine-to-ATP ratio offered important information concerning the degree of dysfunction and prognosis in patients with cardiomyopathy. In the present study, we investigated total creatine (CR) levels in various diseased hearts using 1H MRS. Methods and Results Fourteeen patients with the following conditions were examined: cardiac amyloidosis (n=2); hypertensive heart disease (4); valvular disease (2); hypertrophic cardiomyopathy (2); dilated cardiomyopathy (2); restrictive cardiomyopathy (1); and post-operative atrial septal defect (1). Myocardial CR was measured using 1H MRS with point-resolved spectroscopy localization. Overall, myocardial CR levels in diseased hearts were significantly lower than those in the control group [16.5±6.0 (n=14) vs 27.1±3.2 μmol/g (n=10), p<0.001]. There was a positive correlation between myocardial CR and left ventricular ejection fraction (42.9±13.8%, range 19.5-69.1%) despite the different mechanisms of cardiac dysfunction (r=0.60, p<0.05). Myocardial CR levels in patients who were hospitalized due to heart failure within 1 year were significantly lower than those in other patients [11.3±1.0 (n=4) vs 18.6±5.9 μmol/g (n=10), p<0.05]. Conclusions Noninvasive measurement of myocardial CR using 1H MRS may be valuable in the assessment of disease severity and prediction of clinical course in various forms of heart disease. (Circ J 2005; 69: 711 - 716)<br>

Journal

  • Circulation Journal

    Circulation Journal 69 (6), 711-716, 2005

    The Japanese Circulation Society

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