Studies of energy metabolism in calf muscle of patients suffering from arteriovenous occlusive disease before and after lumbar sympathicolysis using 31P-MR spectroscopy

In 9 patients with arterial occlusive disease of grade IV according to Fontaine, energy metabolism was measured in the calf muscle during rest, before and after lumbar symphathicolysis, by means of 31phosphorus MR spectroscopy. The concentration of inorganic phosphate (Pi) and phosphocreatine (PCr) relative to high energy phosphates, as well as the pH value in muscle cells were assessed, and the quotient Pr/PCr was calculated for estimation of energy reserves. Before sympathicolysis, normal concentrations of the energy suppliers ATP and PCr were unexpectedly found in combination with reduced cellular energy reserves. After lumbar sympathicolysis, in most cases no significant changes of muscle energy metabolism were detected. Independent of the muscle energy supply, a slight increase in energy supply without returning to normal values was found in only three patients. In most patients the clinical symptoms had improved at least to some extent. (orig.)