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Titolo:
MYOCARDIAL PHOSPHOCREATINE-TO-ATP RATIO IS A PREDICTOR OF MORTALITY IN PATIENTS WITH DILATED CARDIOMYOPATHY
Autore:
NEUBAUER S; HORN M; CRAMER M; HARRE K; NEWELL JB; PETERS W; PABST T; ERTL G; HAHN D; INGWALL JS; KOCHSIEK K;
Indirizzi:
UNIV WURZBURG,MED KLIN,DEPT MED,JOSEF SCHNEIDER STR 2 D-97080 WURZBURG GERMANY UNIV WURZBURG,DEPT RADIOL D-97080 WURZBURG GERMANY MASSACHUSETTS GEN HOSP,CARDIAC COMP CTR BOSTON MA 02114 HARVARD UNIV,SCH MED,NMR LAB PHYSIOL CHEM BOSTON MA 00000
Titolo Testata:
Circulation
fascicolo: 7, volume: 96, anno: 1997,
pagine: 2190 - 2196
SICI:
0009-7322(1997)96:7<2190:MPRIAP>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAGNETIC-RESONANCE SPECTROSCOPY; CONGESTIVE-HEART-FAILURE; CORONARY-ARTERY DISEASE; P-31 MR SPECTROSCOPY; DECREASED ENERGY RESERVE; CREATINE-KINASE REACTION; BIOENERGETIC CONSEQUENCES; CARDIAC METABOLISM; SKELETAL-MUSCLES; INFARCTION;
Keywords:
SPECTROSCOPY, MAGNETIC RESONANCE; MORTALITY; HEART FAILURE; METABOLISM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
45
Recensione:
Indirizzi per estratti:
Citazione:
S. Neubauer et al., "MYOCARDIAL PHOSPHOCREATINE-TO-ATP RATIO IS A PREDICTOR OF MORTALITY IN PATIENTS WITH DILATED CARDIOMYOPATHY", Circulation, 96(7), 1997, pp. 2190-2196

Abstract

Background In patients with heart failure due to dilated cardiomyopathy, cardiac energy metabolism is impaired, as indicated by a reductionof the myocardial phosphocreatine-to-ATP ratio, measured noninvasively by P-31-MR spectroscopy. The purpose of this study was to test whether the phosphocreatine-to-ATP ratio also offers prognostic informationin terms of mortality prediction as well as how this index compares with well-known mortality predictors such as left ventricular ejection fraction (LVEF) or New York Heart Association (NYHA) class. Methods and Results Thirty-nine patients with dilated cardiomyopathy were followed up for 928 +/- 85 days (2.5 years). At study entry, LVEF and NYHA class were determined, and the cardiac phosphocreatine-to-ATP ratio wasmeasured by localized P-31-MR spectroscopy of the anterior myocardium. During the study period, total mortality was 26%. Patients were divided into two groups, one with a normal phosphocreatine-to-ATP ratio (>1.60; mean +/- SE, 1.98 +/- 0.07; n=19; healthy volunteers: 1.94 +/- 0.11, n=30) and one with a reduced phosphocreatine-to-ATP ratio (<1.60;1.30 +/- 0.05; n=20). At reevaluation (mean, 2.5 years), 8 of 20 patients with reduced phosphocreatine-to-ATP ratios had died, all of cardiovascular causes (total and cardiovascular mortality, 40%). Of the 19 patients with normal phosphocreatine-to-ATP ratios, 2 had died (total mortality, 11%), one of cardiovascular causes (cardiovascular mortality, 5%). Kaplan-Meier analysis showed significantly reduced total (P = .036) and cardiovascular (P = .016) mortality for patients with normalversus patients with low phosphocreatine-to-ATP ratios. A Cox model for multivariate analysis showed that the phosphocreatine-to-ATP ratio and NYHA class offered significant independent prognostic information on cardiovascular mortality. Conclusions The myocardial phosphocreatine-to-ATP ratio, measured noninvasively with P-31-MR spectroscopy, is apredictor of both total and cardiovascular mortality in patients withdilated cardiomyopathy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 07:24:17