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Rapid Fire Abstracts

Rapid Fire 07- Metabolism, Spectroscopy, Molecular Imaging, and Hyperpolarized MRI & contrast agents

The impact of biological sex and age on the normal ranges of cardiac phosphocreatine to ATP ratio (RF_FR_384)

Friday, January 31, 2025
2:20 PM – 2:30 PM East Coast USA Time
Location: Blue Room PreFunction
Background:

Phosphorus magnetic resonance spectroscopy (31P-MRS) allows non-invasive assessment of the myocardial phosphocreatine to ATP concentration ratio (PCr/ATP), which is a sensitive indicator of the myocardial energetic status.31P-MRS has been used in numerous clinical studies to investigate effects on and changes to cardiac energetics, with consistent reports showing significant reductions in myocardial PCr/ATP ratio in a variety of cardiac conditions including ischaemic heart disease, diabetic cardiomyopathy, aortic stenosis and dilated cardiomyopathy compared to healthy age- and sex-matched controls. We therefore aimed to assess how biological sex and age impact normal ranges of myocardial PCr/ATP ratio.



Methods:

Adult healthy participants with no significant past medical history were recruited in a single-center, prospective cohort study. 31P-MRS was performed to assess myocardial PCr/ATP ratio from a voxel placed in the midventricular septum, with patients lying supine and a 31P transmitter/receiver cardiac coil (Rapid Biomedical GmbH) placed over the heart in a 3.0 T magnetic resonance imaging system (Prisma; Siemens Healthineers, Erlangen, Germany). Coil position was standardized to be placed above the midventricular septum. 31P-MRS analysis was performed offline using the OXSA analysis software within MATLAB.(1) Analysis was performed on two consecutive mid left ventricular slices in the short axis orientation and the average saturation and blood corrected PCr/ATP was reported.



Results:

A total of 120 participants were recruited (mean age 47 years old[CI: 44, 52], mean BMI 24 kg/m2 [CI: 24, 25] for the whole group); ten participants for each group per decade of life.



Examples spectra from both sexes are shown in Figure-1, and Table-1 gives the PCr/ATP ratios.



Comparisons of the average male and female PCr/ATP ratios per decade showed no statistically significant difference between the sexes at each decade (P value >0.05 for each group per decade of life). The impact of age was more evident in the male cohort with a significant negative correlation between the age and myocardial PCr/ATP ratio, while the correlation between the age and myocardial PCr/ATP ratio for the female cohort did not reach significance (males r=-0.46, P=0.0004; females r=-0.2, P=0.0821) as shown in Figure-2.



Conclusion:

In the healthy adult population the biological sex does not impact myocardial PCr/ATP ratio. While myocardial PCr/ATP ratio reduces significantly with age in healthy males, our data suggest a similar of age and PCr/ATP ratio in healthy females.