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To the Editor: We have recently shown by 31P NMR spectroscopy that abnormalities in the myocardial metabolism occur in asymptomatic patients with hypertrophic cardiomyopathy (HCM).1 HCM is inherited in about half of the patients (familial hypertrophic cardiomyopathy, FHC). Among the most lethal genetic defects is the Arg403Gln mutation in the β-cardiac myosin heavy chain.2 Using a mouse model of this missense mutation, Spindler et al2 showed a possible link between the clinical syndrome of FHC and myocardial energetics by demonstrating decreased phosphocreatine (PCr) and increased inorganic phosphate (Pi) concentrations. …

Differences in Cardiac Energetics Between Patients With Familial and Nonfamilial Hypertrophic Cardiomyopathy