La radiologia medica

, Volume 122, Issue 4, pp 265–272 | Cite as

1H- and 31P-myocardial magnetic resonance spectroscopy in non-obstructive hypertrophic cardiomyopathy patients and competitive athletes

  • Francesco Secchi
  • Giovanni Di Leo
  • Marcello Petrini
  • Riccardo Spairani
  • Marco AlìEmail author
  • Marco Guazzi
  • Francesco Sardanelli
Cardiac radiology



The clinical differentiation between athlete’s heart and mild forms of non-obstructive hypertrophic cardiomyopathy (HCM) is crucial. We hypothesized that differences do exist between the myocardial metabolism of patients with non-obstructive HCM and competitive athletes (CAs). Our aim was to evaluate myocardial metabolism with 31P-MRS and 1H-MRS in HCM patients and CAs.

Materials and methods

After Ethics Committee approval, 15 CAs and 7 HCM patients were prospectively enrolled. They underwent a 1.5-T cardiac MR including electrocardiographically triggered cine images, single-voxel 1H-MRS and multivoxel 31P-MRS. 1H-MRS was performed after imaging using standard coil with the patient in the supine position; thereafter, 31P-MRS was performed using a dedicated coil, in the prone position. Data were reported as median and interquartile range. Mann–Whitney U test was used.


In CAs, left ventricular mass index was 72 (66–83) g/m2, septal thickness 10 (10–11) mm, end diastolic volume index 95 (85–102) ml/m2, end systolic volume index 30 (28–32) ml/m2 and ejection fraction 68% (65–69%); in HCM patients, 81 (76–111) g/m2 (P = 0.052), 18 (15–21) mm (P = 0.003), 73 (58–76) ml/m2 (P = 0.029), 20 (16–34) ml/m2 (P = 0.274) and 68% (55–73%) (P = 1.000), respectively. At 1H-MRS, total lipids were 35 (0–183) arbitrary units (au) for CA and 763 (155–1994) au for HCM patients (P = 0.046). At 31P-MRS, PCr/γATP was 5 (4–6) au for CA and 4 (2–5) au for HCM patients (P = 0.230). Examination time was 20 min for imaging only, 5 min for 1H-MRS and 15 min for 31P-MRS.


We observed a significant increase of myocardial lipids, but a preserved PCr/γATP ratio in the metabolism of HCM patients compared with competitive CAs.


Myocardial metabolism Athlete’s heart Hypertrophic cardiomyopathy Magnetic resonance spectroscopy 



This research received no specific grants from any funding agency in the public, commercial or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

F Secchi and G. Di Leo have been sponsored to congresses by Bracco Imaging SpA (Milan, Italy). F. Sardanelli is on the speaker’s bureau for Bracco Imaging SpA (Milan, Italy) and received research grants from Bayer Healthcare (Berlin, Germany).

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Italian Society of Medical Radiology 2017

Authors and Affiliations

  1. 1.Unit of RadiologyIRCCS Policlinico San DonatoMilanItaly
  2. 2.Postgraduation School in RadiodiagnosticsUniversità degli Studi di MilanoMilanItaly
  3. 3.Ph.D. Course in Integrated Biomedical ResearchUniversità degli Studi di MilanoMilanItaly
  4. 4.Cardiology University DepartmentIRCCS Policlinico San Donato, Università degli Studi di MilanoMilanItaly
  5. 5.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanItaly

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