phosphocreatine and Varicose-Veins

The aim of the present study was to investigate the possibility of phosphorus magnetic resonance spectroscopy (MR spectroscopy) in the diagnosis of metabolic lesions of skeletal musculature in patients with intermittent claudication syndrome, chronic cardiac failure, and varicose diseases of the lower limbs. Studies included 50 males: 20 patients with intermittent claudication, 10 patients with chronic cardiac failure, and 10 patients with varicose veins. The control group consisted of 10 healthy volunteers. The following measures were determined: the phosphocreatinine index, the intracellular pH in the gastrocnemius muscle, and the half-recovery time for the phosphocreatinine index. The phosphocreatinine index and the pH at rest did not differ between study groups. Isotonic exercise produced no change in the phosphocreatinine index in the control group; patients with intermittent claudication showed a 26.1% decrease, patients with chronic cardiac failure showed an 8% decrease, and patients with varicose veins showed a 25.6% decrease. The only group showing a significant decrease in pH during exercise was the group of patients with intermittent claudication. This group also showed an inverse correlation between the pressure index and the extent of the decrease in the phosphocreatinine index. Thus, MR spectroscopy provides a non-invasive diagnostic method for lesions of energy metabolism in skeletal musculature in patients with deranged peripheral hemodynamics.

Topics: Adult; Aged; Arteriosclerosis Obliterans; Biomarkers; Energy Metabolism; Heart Failure; Humans; Intermittent Claudication; Leg; Magnetic Resonance Imaging; Male; Middle Aged; Muscle, Skeletal; Phosphocreatine; Phosphorus; Reference Values; Varicose Veins

The present study objective involved evaluation of possibilities of magnetic resonance spectroscopy with phosphorus (31P-MRS) in diagnosis of metabolic disorders of skeletal muscles in patients with intermittent claudication, chronic heart failure and varicose disease of the lower extremities. In 20 patients with intermittent claudication, 10 patients with chronic heart failure, 10 patients with varicose disease and 10 volunteers, 31P-MRS was performed with 1.5 T MR system (Magnetom SP 63, Siemens). The following parameters were computed: phosphorus-creatinine index, intracellular pH in calf muscle, and time of half-recovery of the phosphorus-creatinine index. At rest, the phosphorus-creatinine indexes were similar in all groups; pH values at rest did not vary either. During isotonic exercise the phosphorus-creatinine index in the control group remained uncharged. In patients with intermittent claudication, the phosphorus-creatinine index at peak of exercise was decreased by 26.1% (p < 0.001), in patients with varicose disease--by 25.6% (p < 0.001), in patients with chronic heart failure by 8% (p < 0.001). PCr recovery half-time was increased in all patients. The patient group with intermittent claudication showed a reverse correlation between the pressure index and the degree of phosphorus-creatinine index decrease.. 31P-MRS makes it possible to carry out non-invasive diagnosis of energy metabolic disorders of skeletal muscles in patients with impaired peripheral hemodynamics.

Topics: Adult; Aged; Arteriosclerosis Obliterans; Biomarkers; Energy Metabolism; Heart Failure; Humans; Hydrogen-Ion Concentration; Magnetic Resonance Spectroscopy; Male; Middle Aged; Muscle, Skeletal; Phosphocreatine; Phosphorus; Varicose Veins