Quantification of Myocardial Creatine and Triglyceride Content in the Human Heart: Precision and Accuracy of in vivo Proton Magnetic Resonance Spectroscopy. Issue 2 (10th February 2021)

• Record Type: Journal Article
• Authors: Bakermans, Adrianus J.; Boekholdt, S. Matthijs; de Vries, Dylan K.; Reckman, Yolan J.; Farag, Emile S.; de Heer, Paul; Uthman, Laween; Denis, Simone W.; Zuurbier, Coert J.; Houtkooper, Riekelt H.; Koolbergen, David R.; Kluin, Jolanda; Planken, R. Nils; Lamb, Hildo J.; Webb, Andrew G.; Strijkers, Gustav J.; Beard, Daniel A.; Jeneson, Jeroen A.L.; Nederveen, Aart J.
• Is Part Of: Journal of magnetic resonance imaging. Volume 54:Issue 2(2021)
• Page Start: 411
• Page End: 420
• Publication Date: 2021-02-10
• Subjects: biopsy -- magnetic resonance spectroscopy -- myectomy -- myocardial metabolism -- triglycerides -- validation; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.27531
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Proton magnetic resonance spectroscopy ( 1 H‐MRS) of the human heart is deemed to be a quantitative method to investigate myocardial metabolite content, but thorough validations of in vivo measurements against invasive techniques are lacking. Purpose: To determine measurement precision and accuracy for quantifications of myocardial total creatine and triglyceride content with localized 1 H‐MRS. Study type: Test–retest repeatability and measurement validation study. Subjects: Sixteen volunteers and 22 patients scheduled for open‐heart aortic valve replacement or septal myectomy. Field Strength/Sequence: Prospectively ECG‐triggered respiratory‐gated free‐breathing single‐voxel point‐resolved spectroscopy (PRESS) sequence at 3 T. Assessment: Myocardial total creatine and triglyceride content were quantified relative to the total water content by fitting the 1 H‐MR spectra. Precision was assessed with measurement repeatability. Accuracy was assessed by validating in vivo 1 H‐MRS measurements against biochemical assays in myocardial tissue from the same subjects. Statistical Tests: Intrasession and intersession repeatability was assessed using Bland–Altman analyses. Agreement between 1 H‐MRS measurements and biochemical assay was tested with regression analyses. Results: The intersession repeatability coefficient for myocardial total creatine content was 41.8% with a mean value of 0.083% ± 0.020% of the total water signal, and 36.7% for myocardial triglyceride content with a mean value of 0.35% ± 0.13% of the total water signal. Ex vivo myocardial total creatine concentrations in tissue samples correlated with the in vivo myocardial total creatine content measured with 1 H‐MRS: n = 22, r = 0.44; P < 0.05. Likewise, ex vivo myocardial triglyceride concentrations correlated with the in vivo myocardial triglyceride content: n = 20, r = 0.50; P < 0.05. Data Conclusion: We validated the use of localized 1 H‐MRS of the human heart at 3 T for quantitative assessments of in vivo myocardial tissue metabolite content by estimating the measurement precision and accuracy. Level of Evidence: 2 Technical Efficacy Stage: 2