Changes in Creatine Kinase (CK) system are observed in heart failure and measurement of CK reaction rate constant (kf) can be useful to monitor pathology. 7T MR scanner offers improved signal to noise and spectral resolution and has potential for robust measurements. In this study we demonstrate novel superfast saturation transfer method (T1nom – method) to measure ATP production rate via CK forward reaction in human hearts at 7T. Spatial localization was achieved by GOIA-1D-ISIS/2D-CSI approach. Our measured kf values were consistent with literature.
The creatine kinase (CK) enzyme catalyzes the reaction that converts adenosine diphosphate (ADP) and phosphocreatine (PCr) to adenosine triphosphate (ATP) and creatine (Cr). This facilitates the production and utilization of ATP by the contractile apparatus. The CK reaction rate can be measured noninvasively by the saturation transfer (ST) MRS techniques with and without spatial localization [1, 2]. Using the improved signal to noise offered by 7T magnet offers, 3D-CSI localized measurement of CK reaction rate constant in the myocardium were recently demonstrated [3]. However 3D-CSI localization results in long acquisition times and the technique also requires accurate calibration of flip angles using Bloch-Siegert shift which are not ideal for routine clinical research studies. We have previously demonstrated novel superfast saturation transfer method (T1nom – method) to measure transmural ATP production rate via CK forward reaction in pig hearts [4]. The aim of this study was to implement this approach at 7T for in vivo human heart. To avoid contamination of signal from the chest muscle we also incorporated GOIA-1D-ISIS/2D-CSI signal localization with the saturation transfer pulse sequence (Fig 1) [5].
T1nom method uses two partially relaxed spectra without (Mc) and with (Ms) saturation of ϒ-ATP saturation and the CK reaction rate (kf) constant is determined by
$$\frac{Mc}{Ms} = kf \times T1nom+1$$
Spin parameters PCr:ATP = 0.5, T1 PCr = 4.5s, and T1 ATP = 1.8 s, kf CK = 0.3 1/s and kf ATP = 0.18 1/s were numerically simulated with Tsat = 1.8 s and d1 = 1 sec to determine T1nom using Bloch-Mconnell equations. All studies were performed on a Siemens 7T system (Erlangen, Germany) using a 31P/1H surface. Slice localization (3 cm) was achieved by 6 kHz bandwidth and 4ms duration GOIA-W (16, 4) inversion pulse in a 1D-ISIS scheme followed by 1D or 2D phase encoding gradients to obtain localized spectra. 1D-CSI was acquired with 16 phase encoding steps, FOV = 16 cm, spectral width = 6 kHz, averages = 16 and TE = 0.6 sec with 6 minute acquisition time. 2D-CSI was acquired with FOV = 16 cm x 16 cm, matrix = 16 x 8 and 16 averages with 13 minute acquisition time. ϒ-ATP saturation was achieved by repeated application of low powered continuous pulse (99 ms ON and 1 ms OFF) for total duration Tsat = 1.8 s. Spectra was analyzed in jMRUI using the advanced method for accurate, robust, and efficient spectral fitting (AMARES) [6] algorithm and kf was calculated using the above equation. Studies in calf muscle (n = 2) were used to test whether T1nom approach yield the same values for Kf as conventional saturation transfer method with TR = 12 sec and Tsat = 0.2, 0.4, 0.7, 1.3, 2.5, 4, 6 s. The technique was tested for human heart (n = 3).
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