Contributions of 31P-magnetic resonance spectroscopy to the understanding of dilated heart muscle disease

Eur Heart J. 1995 Dec;16 Suppl O:115-8. doi: 10.1093/eurheartj/16.suppl_o.115.


In the present work, we studied clinical and haemodynamic correlates of impaired cardiac high-energy phosphate metabolism in patients with heart failure due to dilated cardiomyopathy (DCM). Myocardial 31P-magnetic resonance (MR) spectra were obtained at 1.5 T in 14 volunteers and 23 patients with DCM (mean ejection fraction 34%) in order to quantify the creatine phosphate (CP)/ATP ratio. In addition, patients underwent cardiac catheterization and echocardiography. Compared to volunteers (2.02 +/- 0.11), CP/ATP ratios were significantly reduced in DCM patients (1.54 +/- 0.10; P < 0.05), indicating impaired high-energy phosphate metabolism. CP/ATP ratios correlated with the clinical severity of heart failure estimated from the NYHA class (r = 0.47, P < 0.01); also, CP/ATP correlated with left ventricular ejection fraction (r = 0.54, P < 0.01) and left ventricular end-diastolic wall thickness (r = 0.51, P < 0.01). Thus, 31P-MR spectroscopy can detect abnormal cardiac high-energy phosphate metabolism in patients with heart failure due to DCM. These abnormalities correlate with clinical and haemodynamic parameters. Future studies will have to determine whether 31P-MR spectroscopy can contribute to the routine clinical evaluation of patients with heart failure.

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Adult
  • Cardiomyopathy, Dilated / diagnosis
  • Cardiomyopathy, Dilated / physiopathology*
  • Energy Metabolism / physiology*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology*
  • Hemodynamics / physiology
  • Humans
  • Magnetic Resonance Spectroscopy*
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Phosphocreatine / metabolism
  • Reference Values
  • Ventricular Function, Left / physiology


  • Phosphocreatine
  • Adenosine Triphosphate