Cardiac energetics are abnormal in Friedreich ataxia patients in the absence of cardiac dysfunction and hypertrophy: An in vivo P-31 magnetic resonance spectroscopy study
R. Lodi et al., Cardiac energetics are abnormal in Friedreich ataxia patients in the absence of cardiac dysfunction and hypertrophy: An in vivo P-31 magnetic resonance spectroscopy study, CARDIO RES, 52(1), 2001, pp. 111-119
Citations number
48
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective: Friedreich ataxia (FRDA), the commonest form of inherited ataxia
, is often associated with cardiac hypertrophy and cardiac dysfunction is t
he most frequent cause of death. In 97%, FRDA is caused by a homoplasmic GA
A triplet expansion in the FRDA gene on chromosome 9q13 that results in def
iciency of frataxin, a mitochondrial protein of unknown function. There is
evidence that frataxin deficiency leads to a severe defect of mitochondrial
respiration associated with abnormal mitochondrial iron accumulation. To d
etermine whether bioenergetics deficit underlies the cardiac involvement in
Friedreich ataxia (FRDA) we measured cardiac phosphocreatine to ATP ratio
non-invasively in FRDA patients. Methods and results: Eighteen FRDA patient
s and 18 sex- and age-matched controls were studied using phosphorus MR spe
ctroscopy and echocardiography. Left ventricular hypertrophy was present in
eight FRDA patients while fractional shortening was normal in all. Cardiac
PCr/ATP in FRDA patients as a group was reduced to 60% of the normal mean
(P <0.0001). In the sub-group of patients with no cardiac hypertrophy PCr/A
TP was also significantly reduced (P <0.0001). Conclusion: Cardiac bioenerg
etics, measured in vivo, is abnormal in FRDA patients in the absence of any
discernible deterioration in cardiac contractile performance. The altered
bioenergetics found in FRDA patients without left ventricle hypertrophy imp
lies that cardiac metabolic dysfunction in FRDA precedes hypertrophy and is
likely to play a role in its development. (C) 2001 Elsevier Science B.V. A
ll rights reserved.