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(Circulation. 1995;92:1274-1283.)
© 1995 American Heart Association, Inc.

Articles

Effect of Left Ventricular Hypertrophy Secondary to Chronic Pressure Overload on Transmural Myocardial 2-Deoxyglucose Uptake

A ³¹P NMR Spectroscopic Study

Jianyi Zhang, MD, PhD; Dirk J. Duncker, MD, PhD; Xu Ya, MD; Yi Zhang, MD; Todd Pavek, BA; Horan Wei, PhD; Hellmut Merkle, PhD; Kâmil Ugurbil, PhD; Arthur H. L. From, MD; Robert J. Bache, MD

From the Departments of Medicine (J.Z., D.J.D., T.P., A.H.L.F., R.J.B.), Biochemistry (K.U.), and Radiology (K.U.) and the Center for Magnetic Resonance Research (J.Z., X.Y., Y.Z., H.W., H.M., K.U.), University of Minnesota Health Sciences Center and the Department of Veterans Affairs Medical Center (A.H.L.F.), Minneapolis.

Correspondence to Robert J. Bache, MD, Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Box 508, UMHC, Minneapolis, MN 55455.

Background This study tested the hypothesis that ³¹P nuclear magnetic resonance (NMR)–detectable 2-deoxyglucose (2DG) uptake is increased in chronically pressure-overloaded hypertrophied left ventricular myocardium.

Methods and Results ³¹P NMR spectroscopy was used to determine the transmural distribution of high-energy phosphate levels and 2-deoxyglucose-6-phosphate (2DGP) accumulation during intracoronary infusion of 2DG (15 µmol · kg body wt^-1 · min^-1) in eight normal dogs and in eight dogs with severe left ventricular hypertrophy (LVH) produced by ascending aortic banding. The ratio of LV weight to body weight was 8.25±0.65 g/kg in the LVH group compared with 4.35±0.11 g/kg in the normal group (P<.01). Myocardial ATP content was decreased by 40% and phosphocreatine (PCr) by 60% in LVH hearts. ATP values were transmurally uniform in LVH and normal hearts, whereas PCr was lower in the subendocardium (Endo) than the subepicardium (Epi) of both groups. The PCr/ATP ratio was lower in LVH hearts (1.72±0.05, 1.64±0.07, and 1.53±0.10 in Epi, midwall, and Endo, respectively) compared with normal hearts (2.36±0.05, 2.09±0.06, and 1.96±0.06; each P<.01 normal versus LVH). Arterial blood levels of glucose, insulin, and free fatty acids were comparable between groups, whereas arterial lactate and norepinephrine levels were significantly higher in the LVH group. 2DG infusion did not affect systemic hemodynamics or myocardial high-energy phosphate or inorganic phosphate levels in either group. At the end of 60 minutes of 2DG infusion, there was no detectable accumulation of 2DGP in the normal hearts. However, seven of the eight LVH hearts showed time-dependent accumulation of 2DGP, which was linearly related to the severity of hypertrophy (r=.90 for subendocardial 2DGP versus LV weight/body weight). A transmural gradient of 2DGP was present, with greatest accumulation in the subendocardium (3.3±1.6, 5.8±2.3, and 7.9±2.2 µmol/g in Epi, midwall, and Endo of the LVH hearts, respectively; P<.05 Epi versus Endo).

Conclusions The pressure-overloaded hypertrophied left ventricle demonstrated increased accumulation of 2DGP detected with ³¹P NMR spectroscopy. Accumulation of 2DGP was positively correlated with the degree of hypertrophy and was most marked in the subendocardium.

Key Words: hypertrophy • aorta • stenosis • glucose • magnetic resonance imaging

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