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Cited by 197Cardiomyopathy and Myosin StudiesAdvanced MRI Techniques and ApplicationsCardiac Imaging and Diagnostics

31 P NMR Spectroscopy Detects Metabolic Abnormalities in Asymptomatic Patients With Hypertrophic Cardiomyopathy

Jung, Wulf-Ingo, Sieverding, Ludger, Breuer, Johannes, Hoess, Thomas, Widmaier, Stefan, Schmidt, Oliver, Bunse, Michael, van Erckelens, Franz +3 more·1998·Circulation
DOI 10.1161/01.cir.97.25.2536
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Abstract

Background —Hypertrophic cardiomyopathy (HCM) often causes sudden, unexpected death in adolescents and young adults. Alterations in myocardial metabolism are considered to be causes for contractile dysfunction. We examined the question of whether metabolic abnormalities antedate the manifestation of symptoms in patients with HCM. Methods and Results —Proton-decoupled 31 P NMR spectroscopy of the anterior left ventricular wall of the heart of 14 young, asymptomatic patients with HCM was performed with a 1.5-T whole-body imager. Spectra of the phosphate metabolites were compared with those of normal control subjects. The patients exhibited a significantly reduced ( P <0.02) ratio of phosphocreatine (PCr) to ATP of 1.98±0.37 (mean±SD), compared with 2.46±0.53 obtained in 11 normal control subjects. In addition, the group of patients with severe hypertrophy of the interventricular septum (n=8) showed a significantly increased ( P <0.05) P i -to-PCr ratio, with a P i ×100/PCr of 20.0±8.3 versus 9.7±7.2 in control subjects. Both abnormalities are similar to those found in ischemic myocardium. This view is also supported by a significantly increased ( P <0.01) phosphomonoester (PME)-to-PCr ratio, with a PME×100/PCr of 20.7±11.2 compared with 8.4±6.7 in control subjects, indicating altered glucose metabolism. Conclusions — 31 P NMR spectroscopy detects alterations of myocardial metabolism in asymptomatic patients with HCM. These alterations may contribute to the understanding of the pathophysiology and natural history of the disease.

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  • When a possible 35% increase in inorganic phosphate in hypertrophic cardiomyopathy was allowed, the mean free energy of ATP hydrolysis trended lower in patients than in controls.

    “Allowing for a possible 35% increase in inorganic phosphate in HC19 results in a mean free energy release trending lower in HC(−58.5±0.4 in controls vs −57.5 ±1.3 kJ/mol in HC, p=0.05, whereby a more negative ΔG~ATP indicates greater energy release).”

    From iRhythm ZIO: The Diagnostic Yield of a 14-day Continuous Ambulatory ECG Monitor (Turakhia et al., diagnostic yield of extended ambulatory ECG monitoring) (2013) · cites this paper as [19]

    The Results section (‘PCr/ATP Ratio, Pi/PCr Ratio, and pHi’) and Table 2 report altered phosphate ratios in HCM patients, providing a basis for considering increased inorganic phosphate. Our copy does not report a 35% increase in phosphate or calculate the claimed ATP-hydrolysis free energies and their p-value; those specific results are not supported by this source. (LLM, conf=0.84)

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Research works printed but not linked: 6

  1. [1]1. Maron BJ. Hypertrophic cardiomyopathy. Curr Prob Cardiol. 1993;18: 639 -704.
  2. [19]19. Neubauer S, Krahe T, Schindler R, Horn M, Hillenbrand H, Entzeroth C, Mader H, Kromer EP, Riegger GAJ, Lackner K, Ertl G. 31 P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Circulation. 1992;86:1810 -1818.
  3. [26]26. Noggle JH, Schirmer RE. The Nuclear Overhauser Effect. New York, NY: Academic Press; 1971.
  4. [35]35. Schaefer S, Schwartz GG, Gober JR, Wong AK, Camacho SA, Massie B, Weiner MW. Relationship between myocardial metabolites and con- tractile abnormalities during graded regional ischemia. J Clin Invest. 1990;85:706 -713.
  5. [36]36. Arai AE, Grauer SE, Anselone CG, Pantely GA, Bristow D. Metabolic adaption to a gradual reduction in myocardial blood flow. Circulation. 1995;92:224 -252.
  6. [40]40. Taegtmeyer H. Myocardial metabolism. In: Phelps M, Mazziotta J, Schelbert H, eds. Positron Emission Tomography: Principles and Appli- cations for Brain and Heart. New York, NY: Raven Press; 1986: 149 -195.

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Authors
Jung, W.-I., Sieverding, L., Breuer, J., Hoess, T., Widmaier, S., Schmidt, O., Bunse, M., van Erckelens, F., Apitz, J., Lutz, O., & Dietze, G. J.
Affiliations
  • Max Grundig Klinik (DE)
  • From the Hypertension and Diabetes Research Unit, Max Grundig Clinic, Bühl (W.-I.J., T.H., S.W., M.B., F.v.E., G.J.D.); the Division of Pediatric Cardiology, University of Tübingen (L.S., J.B., O.S., J.A.); and the Physikalisches Institut, University of Tübingen (W.-I.J., T.H., S.W., O.S., M.B., O.L.), Germany.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-06-30
Volume
97
Issue
25
Pages
2536-2542
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.97.25.2536
OpenAlex
W2014371939
Cited by
197
References
43
Citations by year
2026: 6 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 2 · 2021: 3 · 2020: 10 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 6 · 2014: 8 · 2013: 6 · 2012: 6
FWCI
5.04
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Eberhard Karls Universität Tübingen
  • Alfried Krupp von Bohlen und Halbach-Stiftung
  • Deutsche Herzstiftung
  • Hans und Gertie Fischer-Stiftung
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords
hypertrophic cardiomyopathy, asymptomatic patients, myocardial metabolism, phosphocreatine to ATP ratio, inorganic phosphate, phosphomonoesters, glucose metabolism, interventricular septal hypertrophy, sudden cardiac death, 31P NMR
MeSH terms
Adolescent, Adult, Cardiomyopathy, Hypertrophic, Child, Female, Humans, Male, Myocardium, Magnetic Resonance Spectroscopy, Phosphorus Isotopes, Case-Control Studies, Myocardial Ischemia

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