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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 Lau1,2, Jane Ellis1, Mark Peterzan1, Moritz Hundertmark1, Damian Tyler3,4, Albrecht Ingo Schmid4,5, Stefan Neubauer6, Oliver Rider6, Ladislav Valkovic6,7, 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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