Wrist flexor muscles of elite rowers measured with magnetic resonance spectroscopy

We used phosphorus magnetic resonance spectroscopy to study skeletal muscle metabolism of trained vs. untrained humans. The forearms of highly trained rowers (n = 10) and age-matched controls were placed in a 1.9-T magnet so that the wrist flexor muscles were placed over a 4-cm transmitting and receiving coil. The subjects performed work by depressing a handle attached to an isokinetic ergometer. Relative concentrations of Pi, phosphocreatine (PCr), and ATP were measured along with intracellular pH. Measurements were made at rest, during steady-state and ramp exercise protocols, and during recovery from exercise. At rest the rowers had Pi/PCr that were not different from control. During steady-state exercise rowers (n = 4) had lower Pi/PCr at the same relative power levels, and the slope of the power vs. Pi-PCr curve was significantly greater than for controls. Rowers (n = 4) also had faster rates of PCr recovery after exercise than controls (T1/2 of 24 +/- 2.0 s for rowers and 47 +/- 8.4 s for controls) when power level was adjusted so that all subjects recovered from the same level of Pi/PCr. During a ramp exercise protocol, the initial slope of the power vs. Pi-PCr curve was greater in three of six rowers compared with controls and at the highest power level rowers had lower Pi/PCr values with less drop in pH. At the end of the ramp test, the same degree of muscle fatigue was associated with much lower levels of H2PO-4 (5.7 +/- 0.70 mM) in rowers compared with controls (13.0 +/- 1.8 mM).(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of abnormal calf muscle metabolism in patients with heart failure using phosphorus-31 nuclear magnetic resonance

Patients with heart failure frequently report leg fatigue during exercise. At present, however, there is no objective method of detecting leg muscle abnormalities in such patients. To determine if phosphorus-31 nuclear magnetic resonance spectroscopy can provide such information, this technique was used to compare calf responses to stair climbing and plantarflexion in 20 patients with heart failure (peak oxygen consumption (VO2) of 13.6 +/- 5 ml/kg/min, ejection fraction 20 +/- 5%) and 9 age-matched normal subjects. Work was quantified by measuring VO2. At rest, both groups exhibited similar inorganic phosphorus to phosphocreatine (Pi/PCr) ratios (patients with heart failure 0.21 +/- 0.07, normal subjects 0.21 +/- 0.06, difference not significant) and pH levels (patients with heart failure 7.06 +/- 0.17, normal subjects 7.05 +/- 0.11, difference not significant). In both normal subjects and patients with heart failure, exercise resulted in a progressive rise in Pi/PCr as VO2 increased. However, examination of the relation of VO2 versus Pi/PCr revealed steeper slopes in patients with heart failure during both stair climbing and plantar-flexion. Neither form of exercise decreased calf pH in normal subjects. In the patients with heart failure, significant decreases in pH were noted during the highest work level of plantarflexion (pH of heart failure patients 6.86 +/- 0.20, pH of normal subjects 7.07 +/- 0.14, p less than 0.01). Metabolic recovery time was also prolonged in the patients with heart failure versus normal subjects (3.3 +/- 0.8 vs 2.1 +/- 0.5 minutes, respectively, p less than 0.002). These findings indicate that phosphorus-31 nuclear magnetic resonance provides objective evidence of leg muscle abnormalities in patients with heart failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Non-invasive evaluation of malignant hyperthermia susceptibility with phosphorus nuclear magnetic resonance spectroscopy

Using in vivo 31P NMR spectroscopy, the authors compared the NMR spectra of the flexor muscles of the forearm from 13 humans characterized as MH susceptible on the basis of in vitro caffeine/halothane contracture tests with those from 25 normal controls. The levels of phosphocreatine (PCr), inorganic phosphate (Pi), and ATP during rest, graded exercise, and post-exercise recovery were measured in their forearms. MH susceptible subjects had significantly (P less than 0.001) higher Pi/PCr values (0.222 +/- 0.009) at rest than did normal controls (0.140 +/- 0.004). In addition, a significantly (P less than 0.01) slower post-exercise recovery rate was found in the MH-susceptible group. There was no significant difference between the two groups in the relationship of work rate to Pi/PCr. These data suggest that unchallenged MH susceptible patients can be distinguished from normals using 31P NMR spectroscopy. The potential use of this technique as a non-invasive tool in determining MH susceptibility is discussed, as well as the possible mechanisms underlying the observed 31P NMR abnormalities.