March 23, 2000

BIRMINGHAM, AL — Women who are hospitalized with chest pain that appears to be related to the heart often are discharged without an explanation for their symptoms.

But in the March 22 issue of the New England Journal of Medicine, a multi-center study led by UAB Cardiologist Gerald M. Pohost, M.D., identified an abnormality using a magnetic resonance procedure in 20 percent of women who underwent catheterization and had no significant coronary artery disease. Women hospitalized with chest pain are much more likely than men to have normal coronary artery angiograms, notes Pohost.

"Our findings suggest that nuclear magnetic resonance (NMR) spectroscopy could serve as a method for early detection of heart disease in women with chest pain in the absence of significant blockages in the larger arteries," Pohost said. "Having a noninvasive method to demonstrate an abnormality in this group of women with chest pain should provide an explanation for those many women who have unexplained, bothersome chest pain and could lead to the development of a treatment."

“We’ve directly examined the heart’s metabolism using a method related to MRI known as spectroscopy," said Steven D. Buchthal, Ph.D., lead author of the study. "Phosphorus spectroscopy, like MRI, uses a magnetic field and radio waves to measure the amount of phosphates in the heart. Phosphates in the heart muscle indicate how well energy is used to fuel the muscle’s contractions.”

The ratios of certain phosphates such as ATP were determined in 35 women with chest pain who showed no signs of significant coronary artery blockage with catheterization. Phosphates were measured at rest and during exercise using a handgrip while in the magnet. Seven of the women showed large decreases in one of the phosphates with exercise. Buchthal said this finding suggests inadequate blood flow during exercise probably related to disease of the very small arteries that can not be visualized by catheterization.