HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Perseghin, G. Articles by Del Maschio, A. Search for Related Content PubMed PubMed Citation Articles by Perseghin, G. Articles by Del Maschio, A.

CLINICAL RESEARCH: CARDIAC IMAGING

Cross-Sectional Assessment of the Effect of Kidney and Kidney-Pancreas Transplantation on Resting Left Ventricular Energy Metabolism in Type 1 Diabetic-Uremic Patients

A Phosphorous-31 Magnetic Resonance Spectroscopy Study

Gianluca Perseghin, MD^_*,,_*, Paolo Fiorina, MD, Francesco De Cobelli, MD^,, Paola Scifo, PhD^,||, Antonio Esposito, MD, Tamara Canu, PhD, Massimo Danna, PhD^||, Chiara Gremizzi, MD, Antonio Secchi, MD, Livio Luzi, MD^_*,,¶ and Alessandro Del Maschio, MD^,

^_* Division of Internal Medicine-Section of Nutrition/Metabolism
Unit of Clinical Spectroscopy, Universitá Vita e Salute San Raffaele, Milan, Italy
Internal Medicine-Section of Organ Transplantation, Universitá Vita e Salute San Raffaele, Milan, Italy
Division of Diagnostic Radiology, Universitá Vita e Salute San Raffaele, Milan, Italy
^|| Division of Nuclear Medicine, Universitá Vita e Salute San Raffaele, Milan, Italy
^¶ Faculty of Exercise Sciences, Universitá degli Studi di Milano, Milan, Italy.

Manuscript received January 10, 2005; revised manuscript received May 23, 2005, accepted May 24, 2005.

^_* Reprint requests and correspondence: Dr. Gianluca Perseghin, Section of Nutrition/Metabolism & Unit of Clinical Spectroscopy, Istituto Scientifico H San Raffaele Internal Medicine, via Olgettina 60, 20132 Milan, Italy. (Email: perseghin.gianluca{at}hsr.it).

OBJECTIVES: To test whether left ventricular (LV) dysfunction affecting type 1 diabetic-uremic patients was associated with abnormal heart high-energy phosphates (HEPs) and to ascertain whether these alterations were also present in recipients of kidney or kidney-pancreas transplantation.

BACKGROUND: Heart failure is the major determinant of mortality in patients with diabetic uremia. Both uremia and diabetes induce alterations of cardiac HEPs metabolism.

METHODS: Magnetic resonance imaging and phosphorous magnetic resonance spectroscopy of the LV were performed in the resting state by means of a 1.5-T clinical scanner. Eleven diabetic-uremic patients, 5 nondiabetic patients with uremia, 11 diabetic recipients of kidney transplantation, and 16 diabetic recipients of combined kidney-pancreas transplantation were studied in a cross-sectional fashion. Eleven nondiabetic recipients of kidney-only transplant and 13 healthy subjects served as control groups.

RESULTS: Uremic patients had higher LV mass, diastolic dysfunction, and lower phosphocreatine (PCr)/adenosine triphosphate (ATP) ratio in comparison with recipients of kidney-pancreas or nondiabetic recipients of kidney transplant. In diabetic recipients of kidney transplant the PCr/ATP ratio was higher than in uremic patients but was lower than in the controls. Recipients of combined kidney-pancreas transplant had a higher ratio than uremic patients but no difference was found in comparison with controls.

CONCLUSIONS: Altered resting myocardial HEPs metabolism may contribute to LV dysfunction in diabetic-uremic patients. In diabetic recipients of kidney transplantation, a certain degree of LV metabolic and functional impairment was found. In combined kidney-pancreas recipients the resting LV metabolism and function were not different than in controls.

Abbreviations and Acronyms   E/A ratio = E-peak filling rate/A-peak filling rate ratio   ECG = electrocardiogram/electrocardiographic   HEPs = high-energy phosphates   LV = left ventricle   MRI = magnetic resonance imaging   NYHA = New York Heart Association   PCr/ATP = phosphocreatine/adenosine triphosphate   31P-MRS = phosphorous-31 magnetic resonance spectra/spectroscopy   rCRSD = relative Cramer-Rao standard deviation

This article has been cited by other articles:

				G. Perseghin, G. Ntali, F. De Cobelli, G. Lattuada, A. Esposito, E. Belloni, T. Canu, F. Costantino, F. Ragogna, P. Scifo, et al. Abnormal Left Ventricular Energy Metabolism in Obese Men With Preserved Systolic and Diastolic Functions Is Associated With Insulin Resistance Diabetes Care, June 1, 2007; 30(6): 1520 - 1526. [Abstract] [Full Text] [PDF]

				P. Fiorina, G. Perseghin, F. De Cobelli, C. Gremizzi, A. Petrelli, L. Monti, P. Maffi, L. Luzi, A. Secchi, and A. Del Maschio Altered Kidney Graft High-Energy Phosphate Metabolism in Kidney-Transplanted End-Stage Renal Disease Type 1 Diabetic Patients: A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation Diabetes Care, March 1, 2007; 30(3): 597 - 603. [Abstract] [Full Text] [PDF]

				F. De Cobelli, M. Pieroni, A. Esposito, C. Chimenti, E. Belloni, R. Mellone, T. Canu, G. Perseghin, C. Gaudio, A. Maseri, et al. Delayed Gadolinium-Enhanced Cardiac Magnetic Resonance in Patients With Chronic Myocarditis Presenting With Heart Failure or Recurrent Arrhythmias J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1649 - 1654. [Abstract] [Full Text] [PDF]