Determinaciones de niveles de creatina y lípidos mediante espectroscopia por resonancia magnética en miocardio de pacientes con insuficiencia cardiaca no isquémica

• JOSÉ LUIS WINTER ^[1] ; PABLO CASTRO ^[1] ; LUIS MENESES ^[1] ; MÓNICA CHALHUB ^[1] ; HUGO VERDEJO ^[1] ; DOUGLAS GREIG ^[1] ; LUIGI GABRIELLI ^[1] ; MARIO CHIONG ^[2] ; ROBERTO CONCEPCIÓN ^[3] ; ROSEMERIE MELLADO ^[1] ; CLAUDIA HERNÁNDEZ ^[1] ; SERGIO URIBE ^[1] ; SERGIO LAVANDERO ^[2]
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  2. [2] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  3. [3] Hospital Dipreca

     Hospital Dipreca

     Santiago, Chile

     

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 138, Nº. 12, 2010, págs. 1475-1479
• Idioma: español
• Títulos paralelos:
  • Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure
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• Resumen

  • Background: Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/ creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites. Aim: To measure myocardial creatine and lipids by MR spectroscopy among patients with HF. Material and Methods: Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in fve patients with non-ischemic heart failure, aged 58 ± 9.7 years, (60% males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained. Results: Among patients, left ventricular ejection fraction was 32 ± 6.9%, 60% were in functional capacity II, 60% had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/ Cr index, among patients with heart failure, when compared with healthy controls (1.46 ± 1.21 and 5.96 ± 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 ± 2.66 and 1.80 ± 1.62 respectively, p = 0.08). Conclusions: Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy.