Abstract
Cardiovascular disease is commonly observed in patients with chronic renal failure and this is a leading cause of death in patients with end-stage renal disease undergoing maintenance dialysis. Myocardial energy production is a very crucial aspect of cardiac function. Therefore, to evaluate energy metabolism of myocardial muscle in peritoneal dialysis (PD) patients, we carried out the following study using Magnetic resonance spectroscopy (MRS).
Fourteen chronic renal failure patients and eight healthy volunteers were enrolled. The ratio of the phosphocreatine peak to the beta-phosphate to ATP peak (PCr/β-ATP) was calculated from their MR spectra obtained by 31P-MR spectroscopy (Gyroscan S15, Philips). To determine the correlation between cardiac function and energy status, the left atrial diameter, the left ventricular (LV) end-diastolic diameter, the ejection fraction, the fraction of shortening and the LV mass index were measured by echocardiography. Peripheral blood sampling was also performed for creatinine, blood urea nitrogen, hematocrit, hemoglobin, β2-microglobuline, intact parathyroid hormone.
PCr/β-ATP was significantly lower in PD (1.03 ± 0.15 vs. 1.40 ± 0.18: p = 0.0002), although all patients showed normal systolic function. No correlation was found between PCr/β-ATP and cardiac function or hematological or biochemical markers. A negative correlation was present between PCr/β-ATP and dialysis duration (r = 0.57, p < 0.05).
Altered energy status of the myocardium in PD should be considered even if the patients did not show any systolic dysfunction. 31P-MRS is a useful tool to evaluate the energy status of the myocardium.
Similar content being viewed by others
References
Horl WH, Riegel W: Cardiac depressant factors in renal disease. Circulation 87(supple IV): IV77-IV82, 1993
Akiba T (ed).: An Overview of Regular Dialysis Treatment in Japan, 2001, p 89
Kawaguchi T, Nishizawa Y, Konishi T et al.: High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int 48: 820-826, 1995
Gejo F, Yamada T, Odani S, Nakagawa Y et al.: A new form of amyloid protein associated with chronic hemodialysis was identified as β2-microglobuli. Biophys Res Commun 129: 701-706, 1985
Isaacs H: Electromyographic study of muscle weakness in chronic renal failure. S A Med J: 683-688, 1969
Brautbar N: Skeletal myopathy in uremia: Abnormal energy metabolism. Kid Int 24: S81-S86, 1983
Van Es A, Henny FC, Kooista MP, Lobatto S, Scholtte HR: Amelioration of cardiac function by L-carnitine administration in patients on hemodialysis. Contrib Nephrol 92: 28-35, 1992
Kramer W, Wizemann V, Lämmlein, Thormann J, Kindler M, Schlepper M, Schütterle G: Cardiac dysfunction in patients on maintenance hemodialysis. Contrib Nephrol 52: 110-124, 1986
Kooman JP, Wijnen JAG, Draaijer P, van Bortel L, Gladziwa U, Struyker-Bboudier HAJ, Peltenburg HG, van Hooff JP, Leunissen KML: Compliance and reactivity of the peripheral venous system in patients treated with chronic intermittent hemodialysis. Kidney Int 41: 1041-1048, 1992
Ritz E, Rambausek M, Mall G, Ruffman K, Mandelbaum A: Cardiac changes to uremia and their possible relation to cardiovascular instability on dialysis. Contrib Nephrol 78: 221-229, 1990
Ogimoto G: Energy metabolism of skeletal muscle on chronic renal failure. St. Marianna Med J 20: 540-549, 1992
Van Dobbenburgh JO, Lekkerkerk C, van Echteld JA: Saturation correlation in human cardiac 31P MR spectroscopy at 1.5T. NMR Biomed 7: 218-224, 1994
London GM, Guefin AP, Pannier B, Safar ME, Dat M, Metivier F: Cardiac and arterial interactions in end-stage renal disease. Kidney Int 50: 600-608, 1996
Hüting J, Kramer W, Reitinger J, Kühn K, Wizemann V, Schütterle G: Cardiac structure and function in continuous ambulatory peritoneal dialysis: Influence of blood purification and hypercirculation. Am Heart J 119: 344-352, 1990
Tagami T, Sakuma H, Matsumura K, Takeda K, Mori S, Takeuchi T, Nakano T: Evaluation of altered myocardial high energy phosphate metabolism in patients on maintenance dialysis using phosphorus-31 magnetic resonance spectroscopy. Invest Radiol 33: 171-176, 1998
Weiss RG, Bottomley PA, Hardy CJ, Gerstenblith G: Regional myocardial metabolism of high-energy phosphates during isometric exercise in patients with coronary artery disease. N Engl J Med 323: 1593-1600, 1990
Schaefer S, Gober JR, Schwartz GG, Twieg DB, Weiner MW, Massie B: In vivo phosphorus-31 spectroscopic imaging in patients with global myocardial disease. Am J Cardiol 65: 1154-1161, 1990
Masuda Y, Tateno Y, Ikehira H et al.: High-energy phosphate metabolism of the myocardium in normal subjects and patients with various cardiomyopathies: The study using ECG gated MR spectroscopy with a localization technique. Jpn Circ J 56: 620-626, 1992
Hardy CJ, Weiss RG, Bottomley PA, Gerstenblith G: Altered myocardial high-energy phosphate metabolites in patients with dilated cardiomyopathy. Am Heart J 122: 795-801, 1991
Vaziri ND: Cardiovascular effects of erythropoietin and anemia correction. Curr Opin Nephrol Hypertens 10: 633-637, 2001
Thompson CH, Kemp GJ, Taylor DJ, Radda GK: Bioenergetic effects of erythropoietin in skeletal muscle. Nephron 74: 239-240, 1996
Bremer J: Carnitine: Metabolism and functions. Physiol Rev 63: 1420-1480, 1983
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ogimoto, G., Sakurada, T., Imamura, K. et al. Alteration of energy production by the heart in CRF patients undergoing peritoneal dialysis. Mol Cell Biochem 244, 135–138 (2003). https://doi.org/10.1023/A:1022470815270
Issue Date:
DOI: https://doi.org/10.1023/A:1022470815270