EVALUATION OF ALTERED MYOCARDIAL HIGH-ENERGY PHOSPHATE-METABOLISM IN PATIENTS ON MAINTENANCE DIALYSIS USING P-31 MAGNETIC-RESONANCE SPECTROSCOPY

RATIONALE AND OBJECTIVES, Assessment of left ventricular metabolism an d function is important in patients on. maintenance dialysis because c ongestive heart failure occurs quite frequently and has a poor prognos is, The purpose of this study was to evaluate the changes of myocardia l high. energy metabolism in dialysis patients by using phosphorus-31 (P-31) magnetic resonance (MR) spectroscopy. METHODS. Phosphorus-31 sp ectra were obtained from: anteroseptal wall of the heart in six normal subjects (mean. age, 24+/-1 years) and 14 dialysis patients (mean age , 52+/-11 years), using a 1.5-tesla clinical MR system, Four patients had previous history of heart failure, Echocardiography was performed in all patients to evaluate left ventricular (LV) hypertrophy and LV f unction. RESULTS, The averaged ratio of phosphocreatine (PCr)/beta-ade nosine triphosphate (P-ATP) in dialysis patients (1.15+/-0.25 mean +/- standard deviation), was significantly lower than that in healthy sub jects (1.63+/-0.21; P < 0.01). There was no significant difference in PCr/beta-ATP ratios between the non-LV hypertrophy group (1.21+/-0.24; n = 7) and the LV hypertrophy group (1.09+/-0.24; n = 7), The average d. PCr/beta-ATP ratio in four patients with history of heart fail me ( 0.96+/-0.18) was significantly lower than that of the 10 patients with out history of heart failure (1.22+/-0.23; P < 0.05). CONCLUSIONS. The se results indicate that patients on maintenance dialysis have decreas ed PCr/beta-ATP ratio and P-31 MR spectroscopy can provide noninvasive assessment of altered high energy phosphate metabolism.