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Metabolic response to exercise in malignant hyperthermia‐sensitive patients measured by 31 P magnetic resonance spectroscopy
Author(s) -
Webster D. W.,
Thompson T.,
Gravelle D. R.,
Laschuk M. J.,
Driedger A. A.
Publication year - 1990
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.1910150109
Subject(s) - malignant hyperthermia , intracellular ph , skeletal muscle , medicine , acidosis , in vivo , hyperthermia , muscle biopsy , chemistry , lactic acidosis , anaerobic exercise , endocrinology , lactic acid , nuclear magnetic resonance spectroscopy , pathogenesis , myopathy , nuclear magnetic resonance , biopsy , intracellular , pathology , biochemistry , biology , physiology , bacteria , genetics , microbiology and biotechnology , physics , organic chemistry
The currently favored theory of pathogenesis of malignant hyperthermia (MH) implicates an abnormality in skeletal muscle calcium ion transport. During a MH crisis a profound lactic acidosis occurs and in MH‐sensitive individuals a delayed recovery of venous lactate has been previously noted postexercise. We have used 31 P magnetic resonance spectroscopy to follow noninvasively in vivo changes in muscle of intracellular pH and high‐energy phosphate metabolites during rest, exercise, and recovery of MH‐sensitive subjects. Eleven biopsy‐positive MH‐sensitive patients have been studied and compared to 26 normal subjects. The MH‐sensitive subjects as a group prematurely dropped their intracellular pH during mild aerobic exercise and they demonstrated a marked delay before the recovery of pH after maximal exercise. PCr/(PCr + P i ) ratios also dropped early during exercise but recovered normally. The observed changes in pH and PCr/(PCr + P i ) are consistent with a myopathy in MH‐susceptible individuals. © 1990 Academic Press, Inc.