Contributions of 31P-magnetic resonance spectroscopy to the understanding of dilated heart muscle disease

In the present work, we studied clinical and haemodynamic correlates of impaired cardiac high-energy phosphate metabolism in patients with heart failure due to dilated cardiomyopathy (DCM). Myocardial 31P-magnetic resonance (MR) spectra were obtained at 1.5 T in 14 volunteers and 23 patients with DCM (mean ejection fraction 34%) in order to quantify the creatine phosphate (CP)/ATP ratio. In addition, patients underwent cardiac catheterization and echocardiography. Compared to volunteers (2.02 +/- 0.11), CP/ATP ratios were significantly reduced in DCM patients (1.54 +/- 0.10; P < 0.05), indicating impaired high-energy phosphate metabolism. CP/ATP ratios correlated with the clinical severity of heart failure estimated from the NYHA class (r = 0.47, P < 0.01); also, CP/ATP correlated with left ventricular ejection fraction (r = 0.54, P < 0.01) and left ventricular end-diastolic wall thickness (r = 0.51, P < 0.01). Thus, 31P-MR spectroscopy can detect abnormal cardiac high-energy phosphate metabolism in patients with heart failure due to DCM. These abnormalities correlate with clinical and haemodynamic parameters. Future studies will have to determine whether 31P-MR spectroscopy can contribute to the routine clinical evaluation of patients with heart failure.

Occupational sensitization to Plasmopara viticola

Molds of the class of Oomycetes are of allergologic importance in special cases. However, probes are not commercially available for diagnostic purposes. Our case report is based on the medical history of a greenhouse worker who had atopic syndrome. He handled pure cultures of defined fungi and plants. A sensitization to pseudo mildew growing on grapevine (Plasmopara viticola) was found. Skin prick test and histamine release test results were positive when extract of P. viticola was used. Detection of IgE reactivities against pseudo mildew via binding tests, Western blot analysis, and isoelectric focusing immunoblot confirmed the diagnosis. To our knowledge these results demonstrate for the second time a sensitization to Oomycetes.