High Energy Phosphate Cardiac Energetics Are Abnormal in Primary Biliary Cirrhosis Patients in the Absence of Functional or Anatomical Abnormalities on Structural MRI

Kieren Grant Hollingsworth¹, David EJ Jones², Jessie Pairman², Katherine Wilton², Roy Taylor¹, Julia Lindsay Newton², Andrew Mark Blamire¹

Primary Biliary Cirrhosis is an autoimmune liver disease affecting females from middle age. A follow-up study of 770 PBC patients studies indicated an increased risk of cardiac-related death. Phosphorus MRS and anatomical imaging for cardiac morphology were acquired to look for cardiac metabolic stress and dysfunction. For 15 PBC patients, the PCr/ATP ratio was significantly reduced compared to age and weight-matched control subjects, but there was no difference in left ventricle morphology, suggesting metabolic stress only. There was no correlation between PCr/ATP ratio, fatigue severity or age, suggesting that cardiac metabolic stress is a systemic feature of the disease.