TY - JOUR
T1 - Myocardial high-energy phosphate metabolism and allograft rejection in patients with heart transplants
AU - Bottomley, Paul A.
AU - Weiss, Robert G.
AU - Hardy, Christopher J.
AU - Baumgartner, William A.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1991/10
Y1 - 1991/10
N2 - To determine whether myocardial high-energy phosphate metabolism is altered in cardiac allograft patients undergoing rejection, 14 patients with heart transplants were examined with image-guided, one-dimensional, phase-encoded surface-coil phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy on 19 occasions 39-2,021 days after transplantation. On average, patients underwent mild rejection (detected with endomyocardial biopsy) and had a reduced ratio of anterior myocardial phosphocreatine (PCr) to adenosine triphosphate (ATP) (1.57 ± 0.50 [standard deviation] vs 1.93 ± 0.2; P < .01) compared with that of 17 healthy control subjects. Ratios of PCr to inorganic phosphate also appeared lower whenever detectable. However, P-31 NMR spectroscopy did not permit reliable identification of patients who required augmented therapy for rejection detected with biopsy either on the day of the P-31 NMR spectroscopic study or at the next scheduled biopsy 10-140 days thereafter (sensitivity, 50%, and specificity, 73% with use of cardiac-averaged PCr/ATP values for each heart; sensitivity, 88%, and specificity, 55% with use of the lowest myocardial PCr/ATP ratios measured in each heart).
AB - To determine whether myocardial high-energy phosphate metabolism is altered in cardiac allograft patients undergoing rejection, 14 patients with heart transplants were examined with image-guided, one-dimensional, phase-encoded surface-coil phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy on 19 occasions 39-2,021 days after transplantation. On average, patients underwent mild rejection (detected with endomyocardial biopsy) and had a reduced ratio of anterior myocardial phosphocreatine (PCr) to adenosine triphosphate (ATP) (1.57 ± 0.50 [standard deviation] vs 1.93 ± 0.2; P < .01) compared with that of 17 healthy control subjects. Ratios of PCr to inorganic phosphate also appeared lower whenever detectable. However, P-31 NMR spectroscopy did not permit reliable identification of patients who required augmented therapy for rejection detected with biopsy either on the day of the P-31 NMR spectroscopic study or at the next scheduled biopsy 10-140 days thereafter (sensitivity, 50%, and specificity, 73% with use of cardiac-averaged PCr/ATP values for each heart; sensitivity, 88%, and specificity, 55% with use of the lowest myocardial PCr/ATP ratios measured in each heart).
KW - Heart, radionuclide studies, 51.1299
KW - Heart, transplantation, 51.459
KW - Magnetic resonance (MR), phosphorus studies, 51.1214
KW - Magnetic resonance (MR), spectroscopy, 51.1214
UR - http://www.scopus.com/inward/record.url?scp=0026004892&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026004892&partnerID=8YFLogxK
U2 - 10.1148/radiology.181.1.1887057
DO - 10.1148/radiology.181.1.1887057
M3 - Article
C2 - 1887057
AN - SCOPUS:0026004892
VL - 181
SP - 67
EP - 75
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 1
ER -