Our preliminary data suggested a decrease of human myocardial, high-energy, phosphate metabolism in patients with hypercholesterolemia. Therefore we intended to prove its association with established cardiovascular risk scores.
Our study included 99 healthy, asymptomatic male patients (mean age 52.2 +/- 8.8) with normal ejection fraction. All underwent echocardiography and cycle ergometry to exclude a latent coronary insufficiency. Blood was taken to evaluate cardiovascular risk scores: ESC cardiovascular (CV) risk, ESC coronary heart disease (CHD) risk, Procam and Framingham CHD score. Then Phosphorus-31, two-dimensional chemical shift imaging (31P 2D CSI) of the heart was performed in all subjects using a 1.5 Tesla whole-body magnetic resonance (MR) scanner. The ratios (R) between phosphocreatine (PCr) and beta-adenosine-triphosphate (beta-ATP) were calculated for the left ventricular myocardium and divided into tertiles (R1-R3).
There was a significant effect regarding differences across tertiles (R1-R3) within the cardiovascular risk scores (Kruskal Wallis ANOVA for ESC CV, p<0.001; ESC CHD, p<0.001; Procam, p=0.003; Framingham CHD, p<0.001). Bivariat analysis revealed an association between myocardial PCr-beta-ATP ratios and the ESC CV (p<0.001, r= -0.444), ESC CHD (p<0.001, r= -0.434), Procam (p = 0.027, r = -0.222), Framingham CHD (p<0.001, r = -0.380) score and patients with low R had a significant higher risk of cardiovascular events than those in the higher tertiles.
We are the first to show a correlation between the myocardial high-energy, phosphate metabolism and cardiovascular risk scores.
Myocardial high-energy, phosphate metabolism may be of relevance in primary prevention of cardiovascular disease.
Ralf Zwick, None.