Document Detail

Non-invasive magnetic-resonance detection of creatine depletion in non-viable infarcted myocardium.
MedLine Citation:
PMID:  9504516     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preserved energy metabolism is essential for myocardial viability and the creatine kinase reaction is central to energy production and reserve. Although the appearance of myocardial creatine kinase enzyme in the blood is widely used to diagnose cardiac necrosis, there are no non-invasive ways to measure local creatine concentrations in the healthy and diseased human heart. METHODS: We measured total myocardial creatine by spatially-localised, water-suppressed hydrogen magnetic-resonance spectroscopy (1H-MRS) on a clinical (1.5 T) magnetic-resonance-imaging system in ten healthy volunteers (controls) and ten patients with a history of myocardial infarction. We validated this technique by comparison of 1H-MRS values of creatine with biopsy assays in an animal model of infarction. FINDINGS: Total creatine was measured in the posterior and anterior left ventricle and septum, and was significantly lower in regions of infarction (10 [9] SD micromol/g wet weight) than in non-infarcted regions (26 [11] micromol/g, p=0.001) of myocardium in patients or in the myocardium of healthy controls (28 [6] micromol/g, p<0.0001). INTERPRETATION: Spatially localised 1H-MRS can be used to measure total creatine non-invasively throughout the human heart. The detection of regional creatine depletion may provide a metabolic means to distinguish healthy from infarcted non-viable myocardium.
P A Bottomley; R G Weiss
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Lancet     Volume:  351     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-03-19     Completed Date:  1998-03-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  714-8     Citation Subset:  AIM; IM    
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
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MeSH Terms
Creatine / metabolism*
Energy Metabolism
Magnetic Resonance Spectroscopy*
Middle Aged
Myocardial Infarction / metabolism*
Myocardium / metabolism*
Grant Support
Reg. No./Substance:

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