Abstract #0375

Myocardial Pi/PCr and pH during stress at 7T with STEAM 31P MRS in dilated cardiomyopathy; heart failure beyond the ejection fraction.

Andrew Apps¹, Justin Lau^1,2, Jane Ellis¹, Mark Peterzan¹, Moritz Hundertmark¹, Damian Tyler^3,4, Albrecht Ingo Schmid^4,5, Stefan Neubauer⁶, Oliver Rider⁶, Ladislav Valkovic^6,7, and Christopher T Rodgers⁸

¹Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom, ²Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom, ³Physiology Anatomy and Genetics, University of Oxford, Oxford, United Kingdom, ⁴Oxford Centre for Magentic Resonance, University of Oxford, Oxford, United Kingdom, ⁵Medical University of Vienna, Vienna, Austria, ⁶Oxford Centre for Magnetic Resonance, University of Oxford, Oxford, United Kingdom, ⁷Imaging Methods, Slovak Academy of Sciences, Bratislava, Slovakia, ⁸Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom

The addition of Pi/PCr quantification adds value over PCr/ATP for the characterisation of myocardial energetics. In defining the chemical shift of the Pi resonance, pH can also be computed. Such measurements however are hampered in 31P MRS due to the overlapping 2,3-DPG resonance. In harnessing the black blood contrast offered by STEAM, we successfully characterise Pi (and hence myocardial pH) in a cohort of patients with dilated cardiomyopathy. We go on to shown that in these patients (but not controls) Pi/PCr rises significantly during dobutamine stress, a finding that would significantly impair the free energy of ATP hydrolysis during exertion.

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