1H- and 31P-myocardial magnetic resonance spectroscopy in non-obstructive hypertrophic cardiomyopathy patients and competitive athletes
The clinical differentiation between athlete’s heart and mild forms of non-obstructive hypertrophic cardiomyopathy (HCM) is crucial. We hypothesized that differences do exist between the myocardial metabolism of patients with non-obstructive HCM and competitive athletes (CAs). Our aim was to evaluate myocardial metabolism with 31P-MRS and 1H-MRS in HCM patients and CAs.
Materials and methods
After Ethics Committee approval, 15 CAs and 7 HCM patients were prospectively enrolled. They underwent a 1.5-T cardiac MR including electrocardiographically triggered cine images, single-voxel 1H-MRS and multivoxel 31P-MRS. 1H-MRS was performed after imaging using standard coil with the patient in the supine position; thereafter, 31P-MRS was performed using a dedicated coil, in the prone position. Data were reported as median and interquartile range. Mann–Whitney U test was used.
In CAs, left ventricular mass index was 72 (66–83) g/m2, septal thickness 10 (10–11) mm, end diastolic volume index 95 (85–102) ml/m2, end systolic volume index 30 (28–32) ml/m2 and ejection fraction 68% (65–69%); in HCM patients, 81 (76–111) g/m2 (P = 0.052), 18 (15–21) mm (P = 0.003), 73 (58–76) ml/m2 (P = 0.029), 20 (16–34) ml/m2 (P = 0.274) and 68% (55–73%) (P = 1.000), respectively. At 1H-MRS, total lipids were 35 (0–183) arbitrary units (au) for CA and 763 (155–1994) au for HCM patients (P = 0.046). At 31P-MRS, PCr/γATP was 5 (4–6) au for CA and 4 (2–5) au for HCM patients (P = 0.230). Examination time was 20 min for imaging only, 5 min for 1H-MRS and 15 min for 31P-MRS.
We observed a significant increase of myocardial lipids, but a preserved PCr/γATP ratio in the metabolism of HCM patients compared with competitive CAs.
KeywordsMyocardial metabolismAthlete’s heartHypertrophic cardiomyopathyMagnetic resonance spectroscopy
Autor / Fonte:Francesco Secchi, Giovanni Di Leo, Marcello Petrini, Riccardo Spairani, Marco Alì, Marco Guazzi, Francesco Sardanelli La Radiologia Medica 2017 January 9