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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.

View larger version (58K): [in a new window]   Figure 1 Scout images in the transverse (A) and sagittal (B) image planes and cardiac 31P-spectrum (panel C). In panels A and B, the squares indicate the three-dimensional ISIS volume. In panel C, the 31P-spectrum shows resonance peaks of phosphocreatine (PCr), adenosine triphosphate (ATP), phosphodiesters (PDE), and the combined signals of 2,3-diphosphoglycerate (2,3-DPG) originating from blood and inorganic phosphate (Pi).

View larger version (21K): [in a new window]   Figure 2 Comparison of the left ventricular (LV) phosphocreatine/ATP (PCr/ATP) ratios of diabetic patients with uremia, nondiabetic patients with uremia, diabetic-uremic recipients of kidney transplantation (Tx) alone or combined kidney-pancreas transplantation, nondiabetic uremic recipients of kidney transplantation alone, and normal subjects. One-way analysis of variance and Tukey’s post-hoc tests.

View larger version (19K): [in a new window]   Figure 3 Comparison of the phosphocreatine/ATP (PCr/ATP) ratios of the left ventricle of individuals with established left ventricular (LV) systolic dysfunction (with ejection fraction 35% at echocardiography), diabetic patients with uremia, nondiabetic patients with uremia, and normal subjects. One-way analysis of variance and Tukey’s post-hoc tests.