Tetsuya Matsumoto

Creatine depletion in the non-viable infarcted human heart was previously demonstrated with proton magnetic resonance (MR) spectroscopy (¹H MRS). In the present study, we assessed total creatine (CR) in human hearts with non-ischemic dysfunctions such as cardiomyopathy. Using cardiac-gated ¹H MRS with MR image-guided PRESS localization, we measured septal CR in healthy and diseased human hearts. Fifteen patients with chronic heart failure (CHF, left ventricular ejection fraction <45%) and 14 age-matched normal subjects were examined. Myocardial CR was significantly (p<0.001) lower in failing hearts (15.1±SD 5.0 μmol/g wet weight, range 8.0-22.9) than in normal hearts (27.6±4.1 μmol/g wet weight, range 20.8-36.2). Myocardial CR concentrations in six heart failure patients with plasma B-type natriuretic peptide (BNP) levels of >200 pg/ml (11.5±0.9 μmol/g wet weight, range 9.9-12.3) were significantly lower than those in four heart failure patients with plasma BNP levels of <200 pg/ml (19.8±2.5 μmol/g wet weight, range 17.7-22.9, p<0.001). Thus, our study showed that myocardial CR was decreased in non-ischemic dysfunctional hearts. Noninvasive measurements of myocardial CR by ¹H MRS may be useful in the assessment of the severity of heart failure.<br>