Cardiac (31)P-MRS compared to echocardiographic findings in patients with hypertensive heart disease without overt systolic dysfunction--preliminary results.

Purpose: To evaluate changes in high energy phosphate (HEP) metabolism in patients with hypertension and diastolic dysfunction but with normal LVEF>55% assessed by echocardiography and tissue Doppler.

Material And Methods: 20 patients (16 men and 4 women, mean age 57+/-13 years) were studied with phosphorus magnetic resonance spectroscopy and echocardiography. MRS was performed at 1.5T using an ECG-gated CSI sequence with nuclear Overhauser effect. According to echocardiographical findings 12 patients were found to have a diastolic dysfunction, whereas 8 patients were identified as normal, serving as control group in the following statistical analysis. All patients had normal systolic function (LVEF>55%).Statistical analysis was made by using mean+/-S.D. for description of the data, Spearman correlation and two-tailed Student's t-test for independent samples.

Results: No differences were found in weight, age, LVEF, endsystolic volume, end-diastolic volume, cardiac output and BNP levels between patients and control group. Myocardial mass at end-diastole correlated significantly with PCr/ATP ratio (r=-0.66; p=0.04) in patients and control group. Myocardial PCr/ATP ratio in patients was significantly decreased compared to controls (1.21+/-0.22 vs. 1.54+/-0.24; p=0.006).

Conclusions: Cardiac (31)P-MRS might offer a noninvasive means for detecting early states of heart failure in hypertensive patients.