Correlation of MR changes with Doppler US measurements of blood flow in exercising normal muscle

Effect of muscle glycogen content on exercise-induced changes in muscle T2 times

Effects of gastrocnemius glycogen (Gly) concentration on changes in transverse relaxation time (T2; ms) were studied after 5-min plantar flexion at 25% of maximum voluntary contraction (MVC). Gastrocnemius Gly, phosphorus metabolites, and T2 were measured in seven subjects by using interleaved 13C/31P magnetic resonance spectroscopy (MRS) at 4.7 T and magnetic resonance imaging (MRI; 1.5 T). After baseline MRS/MRI, subjects exercised for 5 min at 25% of MVC and were reexamined (MRS/MRI). Subjects then performed approximately 15 min of single-leg toe raises (50 +/- 2% of MVC), depleting gastrocnemius Gly by 43%. After a 1-h rest (for T2 return to baseline), subjects repeated the 5-min protocol, followed by a final MRI/MRS. After the initial 5-min protocol, T2 values increased by 5.9 +/- 0.8 ms (29.9 +/- 0.4 to 35.8 +/- 0.6 ms), whereas Gly did not change significantly (70.5 +/- 6.8 to 67.6 +/- 7.4 mM). After 15 min of toe raises, gastrocnemius Gly was reduced to 40.4 +/- 5.3 mM (P </= 0. 01), recovering to 45.8 +/- 5.3 mM (P </= 0.05) during a 1-h rest. After the second 5-min bout of plantar flexion (reduced Gly at 25% of MVC), T2 values increased by 5.0 +/- 0.8 ms (30.4 to 35.4 ms), whereas muscle Gly rose to 57.6 +/- 5.3 mM. We conclude that muscle Gly concentration per se does not affect exercise-induced T2 increases in the human gastrocnemius.

Measurement of magnetic resonance T2 for physiological experiments

The proton transverse relaxation time (T2) of human skeletal muscles has been increasingly used in magnetic resonance imaging experiments to examine muscle physiology and neuromuscular control. However, little attention has been paid to the experimental factors affecting the accuracy or sensitivity of the T2 measurement. We have explored theoretically and experimentally the structure of several magnetic resonance pulse sequences for measuring T2 of the first dorsal interosseous muscle and found that a multiecho imaging technique using non-slice-selective refocusing pulses (MENSS) produces more accurate T2 estimates than multiecho slice-selective (MESS) imaging methods that are commonly used. Using either technique we acquired four 5-mm-thick transverse images of the first dorsal interosseous muscle with a spatial resolution of 0.6 mm within 5 min. The T2 measured by the MENSS method was closer to the true T2 than was the T2 estimated by the MESS method. After a given amount of exercise, the MENSS technique revealed an average 28 +/- 10% increase in T2 compared with a 13 +/- 3% increase measured with an equivalent MESS technique. We conclude that the MENSS method is a more accurate and sensitive procedure for studying neuromuscular physiology compared with the more commonly used MESS method.

Dynamic evaluation of exercising leg muscle in healthy subjects with echo planar MR imaging: work rate and total work determine rate of T2 change

Echo planar MR imaging of the leg was performed in nine healthy volunteers to better understand the dynamic relationship between exercise and changes in muscle T2. Imaging and T2 calculation was performed before, during, and after ankle dorsiflexion exercises using a TR of 9 seconds and a TE of 60 msec. Performing 9-second duty cycles, six of the subjects exercised for sets of 12 duty cycles, three with a graded series of weights and pulleys and three with an isometric orthotic device graded in varying percentages of maximum voluntary contraction. The other three volunteers performed duty cycles to fatigue. Gastrocnemius and soleus muscle T2 relaxation times were unchanged before, during, and after exercise. The tibialis anterior muscle showed an initial brief 1.7-6.2% decrease in T2 values after starting exercise, followed by a linear increase. Maximum T2 values and percent changes were higher for higher work rates (P < .05), and the rate of T2 change increased in a linear fashion with increasing work rates. By using rapid serial MR imaging, we show that the rate of muscle T2 change bears a simple linear relationship to muscle work. This technique may be exploited in both diagnostic and rehabilitation procedures.

Prolonged kinetics of recovery of oxygen consumption after maximal graded exercise in patients with chronic heart failure. Analysis with gas exchange measurements and NMR spectroscopy

BACKGROUND

Patients with chronic heart failure (CHF) often complain of prolonged dyspnea after exercise. The determinants of oxygen consumption after exercise in these patients are unknown. We hypothesized that the kinetics of oxygen consumption recovery after graded exercise was prolonged in parallel with the recovery of muscle energy stores, was not affected by the exercise level, and could be used to assess the circulatory response to exercise.

METHODS AND RESULTS

Seventy-two patients with CHF in Weber's class A (n = 28), B (n = 21), and C/D (n = 23) and 13 healthy subjects performed maximal upright bicycle exercise with breath-by-breath respiratory gas analysis. Kinetics of recovery of ventilation (VE), oxygen consumption (VO2), and CO2 production (VCO2) after exercise were characterized by T1/2, the time to reach 50% of the peak value. T1/2 VO2 (seconds) increased with the severity of CHF (97 +/- 17 for CHF A [P < .05 versus CHF B, P < .05 versus CHF C/D], 119 +/- 22 for CHF B [P < .05 versus control subjects, P < .05 versus CHF A, and P < .05 versus CHF C/D], 155 +/- 55 for CHF C/D [P < .05 versus control subjects, P < .05 versus CHF A, and P < .05 versus CHF B] compared with 77 +/- 17 for control subjects). T1/2 VCO2 and T1/2 VE also increased similarly with the worsening of CHF. T1/2 VO2 was correlated negatively with peak VO2 (r = .65) and was reproducible (r = .96). To study the relation between T1/2 VO2 and the duration of exercise, 10 healthy subjects and 22 patients underwent a second graded test at 75% and/or 50% of peak workload. T1/2 VO2 was minimally shortened, at only 50% of peak workload (P = .02). Finally, 19 patients underwent 31P nuclear magnetic resonance spectroscopy of the anterior compartment of the leg during exercise; the half-time of recovery of the ratio of inorganic phosphate to creatine phosphate (T1/2 Pi/PCr), reflecting the level of involvement of oxidative metabolism in the restoration of energetic metabolites after exercise, was linearly correlated with the half-time of VO2 recovery (r = .70, P < .01).

CONCLUSIONS

Postexercise T1/2 VO2 increases when CHF worsens, perhaps in part a result of slower kinetics of recovery of muscle energy stores. The time course of oxygen consumption recovery may represent a simple new criterion for measuring the impairment of the circulatory response to exercise in CHF, even submaximal exercise.

Simultaneous measurements of diffusion and transverse relaxation in exercising skeletal muscle

The aim of this study was to compare proton T2 and apparent diffusion coefficient (ADC) variations induced by exercise in skeletal muscle, to provide some more information on the source of their variations. T2 and ADC were measured in the forearm flexor digitorum muscles in 12 healthy volunteers at rest and after an exercise, using a sequence allowing simultaneous measurements of both parameters. At rest, T2 was 30.6 +/- 1.8 ms (mean +/- 1 SD) and ADC was 1.82 +/- 0.11 x 10(-9) m2/s. With exercise, T2 varied by +2.8 +/- 12% (p < .001 vs. rest) and ADC varied by +12 +/- 3% (p < .001). The recovery of T2 after exercise was faster than that of ADC, with half-times of 7 +/- 2 min and of 15 +/- 8 min (p < .01), respectively. It is concluded that both T2 and ADC with exercise are probably different, T2 mostly reflecting changes in water content and ADC reflecting temperature variations.

Dynamic echo planar imaging of exercised muscle

Echo planar imaging was used to record dynamic changes in tissue transverse relaxation rates (delta R2) in the anterior tibialis muscle during dorsi-flexion exercise and recovery. Using a single spin-echo technique to calculate the change in relaxation rate produced by the exercise a time resolution of 4 s was achieved for each measurement of delta R2. For a fixed workload of 70% of maximum voluntary contraction (MVC), the duration of dorsi-flexion exercise was varied and measurements of delta R2 were obtained throughout exercise and for at lease 5 min of recovery. Comparisons were made between the single echo results and those obtained using multiple echo measurements of T2 with much lower time resolution, to verify that the two techniques gave the same results. We found on average that delta R2 decreased by an average of 8.7 s-1 within the tibialis with an average rate of decrease during exercise of delta R2/ delta t(ex) = -0.061 s-2. For the high time resolution studies we consistently observed that there was a continued decrease in the measured value of delta R2 after the exercise, reaching a minimum value about a minute after the exercise ceased. This average rate of undershoot during the postexercise period was given by delta R2/ delta t(us) = -0.035 s-2. This effect has not been noted previously in MR imaging studies and may be attributed to increased flow within the tissue as contracting muscle fibers relax following exercise. The results can be interpreted using simple fast exchange or slow exchange models for tissue water relaxation. For the case of rapid exchange the changes in delta R2 may be indicative of an increase in the net water volume within the muscles, whereas in the case of slow exchange delta R2 is primarily a measure of intracellular volume increases.

Multiparametric classification of muscle T1 and T2 relaxation times determined by magnetic resonance imaging. The effects of dynamic exercise in trained and untrained subjects

Muscle relaxation times can now be measured accurately with magnetic resonance imaging (MRI), distinguishing working muscles from non-working muscles. A correlation between T2 increase and work intensity has been shown in healthy volunteers. The small amount of data on T1 relaxation times is contradictory. In addition, all the published studies have concerned short-duration exercise in subjects of unknown training level. The goals of this study were (i) to determine T1 and T2 variations in thigh muscles after long dynamic exercise, (ii) to analyse the effects of training and (iii) to determine the relationship between power output and relaxation times after exercise. Sedentary men, soccer players and tri-athletes performed submaximal dynamic exercise at a constant heart rate for 15 min. MRI was performed before and 5 min after the end of exercise. The results showed (i) that T1 increased in parallel to T2 in anterior thigh muscles and (ii) that multiple correspondence analysis and hierarchical ascending classification can discriminate three subjects classes according to power output, training level and relaxation times, which fitted well with our three groups of subjects.