Altered relative concentrations of high-energy phosphates in patients with uraemic cardiomyopathy measured by magnetic resonance spectroscopy

Patel, R.K., Mark, P.B. , Macnaught, G., Stevens, K.K., McQuarrie, E.P., Steedman, T., Gillis, K. , Dargie, H.J. and Jardine, A.G. (2012) Altered relative concentrations of high-energy phosphates in patients with uraemic cardiomyopathy measured by magnetic resonance spectroscopy. Nephrology Dialysis Transplantation, 27(6), pp. 2446-2451. (doi: 10.1093/ndt/gfr688)

Abstract

<p><b>Background:</b> Premature sudden cardiovascular death is the commonest cause of death in end-stage renal disease (ESRD) patients and is associated with uraemic cardiomyopathy [left ventricular hypertrophy (LVH), systolic dysfunction (LVSD) or LV dilation]. High-energy phosphates (HEP), quantified using phosphorus-31 magnetic resonance spectroscopy, are reduced in patients with diabetes, heart failure and uraemia. Phosphocreatine:β adenosine triphosphate (PCr:ATP) ratio is an index of metabolic activity. We compared resting HEPs in ESRD patients and hypertensive patients (with and without LVH) who had normal renal function (LVH-only or normal myocardia). We also assessed associations of HEP levels with abnormalities of uraemic cardiomyopathy.</p> <p><b>Methods:</b> Fifty-three ESRD and 30 hypertensive patients (18 with LVH, 12 with normal myocardia) underwent phosphorus magnetic resonance spectroscopy of their left ventricle. PCr:ATP ratios were calculated from 31P-MR spectra obtained from long-axis views of the left ventricle.</p> <p><b>Results:</b> There were no significant differences in age, LV mass, chamber sizes and ejection fraction between patient groups. PCr:ATP was significantly lower in ESRD patients compared to hypertensive patients, irrespective of the presence or absence of LVH (P = 0.01). In the ESRD group, PCr:ATP was significantly lower in patients with LVSD (P = 0.05) and LV dilation (P = 0.01). LVH was not associated with significant difference in PCr:ATP.</p> <p><b>Conclusions:</b> ESRD patients have lower HEP levels compared to hypertensive patients. Lower PCr:ATP ratio, indicating altered myocardial metabolic function in ESRD patients, is associated with features of uraemic cardiomyopathy.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Patel, Dr Rajan and McQuarrie, Dr Emily and Stevens, Dr Kathryn and Dargie, Professor Henry and Mark, Professor Patrick and Gillis, Dr Keith and Hopkins, Mrs Tracey and Jardine, Professor Alan
• Authors: Patel, R.K., Mark, P.B., Macnaught, G., Stevens, K.K., McQuarrie, E.P., Steedman, T., Gillis, K., Dargie, H.J., and Jardine, A.G.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Nephrology Dialysis Transplantation
• Publisher: Oxford University Press
• ISSN: 0931-0509
• Published Online: 11 January 2012