부산대학교 도서관

4. Conclusions:Evaluation of the myocardial energy metabolism in human endstage heart failure is noninvasively feasible by using31P-MR spectroscopy. The investigations were well tolerated by all patients.The PCr/ATP ratio is significantly diminished in patients with dilated cardiomyopathy.In this study a part of the patients showed a significant increase in the PCr/ATP ratio. A possible explanation for this fact could be the enhancement of muscle structures induced by growth hormone therapy, which could be proven using MR tomography by an increase in myocardial muscle mass. A further point is the improvement or increase in the myocardial energy metabolism and an improvement of the PCr/APT ratio. A final assessment of this issue will be possible in summer 1998 after unblinding the study population.Further studies will have to show whether the increase of the PCr/ATP ratio after r-HGH treatment will be a good predictor for a possible increase of myocardial contractility.Furthermore, long-term studies with a high number of patients are necessary to investigate the effects on the survival prognosis of this new substance.