{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:11Z","timestamp":1787017991246,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2001,6,12]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014Cerebral metabolic abnormalities were proposed as a potential marker of disease severity in congestive heart failure (CHF), but their prognostic significance remains uncertain.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014We investigated the prognostic value of cerebral metabolic abnormalities in 130 consecutive patients with advanced CHF (100 men aged 42.6\u00b111.9 years; left ventricular ejection fraction, 22.2\u00b16.2%). Proton magnetic resonance spectroscopy data were obtained from localized regions (\u22488 mL) of the occipital gray matter and the parietal white matter. The primary end point was the occurrence of death after the proton magnetic resonance spectroscopy. During follow-up (18.5\u00b114.4 months), 21 patients died and 15 underwent urgent heart transplantation. In the Cox proportional model, occipital metabolites (N-acetylaspartate, creatine, choline, and myoinositol), parietal N-acetylaspartate level, and the duration of CHF symptoms (&gt;12 months) were validated as univariate predictors of death. In multivariate Cox analyses, however, the occipital N-acetylaspartate level was an independent predictor of death (hazard ratio, 0.52; 95% CI, 0.41 to 0.67;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). An analysis with respect to the combined end point of death or urgent transplantation showed similar results. The best cutoff value (9.0 mmol\/kg) for occipital N-acetylaspartate level had 75% sensitivity and 67% specificity to predict mortality.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014The occipital N-acetylaspartate level is a powerful and independent predictor of CHF mortality, suggesting that cerebral metabolic abnormalities may be used as a new prognostic marker in the assessment of patients with CHF.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.103.23.2784","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:09:32Z","timestamp":1339445372000},"page":"2784-2787","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Prognostic Significance of Cerebral Metabolic Abnormalities in Patients With Congestive Heart Failure"],"prefix":"10.1161","volume":"103","author":[{"given":"Cheol Whan","family":"Lee","sequence":"first","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Hwan","family":"Lim","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Suk","family":"Yang","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myeong-Ki","family":"Hong","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Kwan","family":"Song","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Wook","family":"Park","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jung","family":"Park","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Joong","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (C.W.L., H.S.Y., M.-K.H., J.-K.S., S.-W.P., S.-J.P., J.-J.K.) and Radiology (T.-H.L.) and the Asan Institute for Life Science (J.H.L.), Asan Medical Center, University of Ulsan, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90812-F"},{"key":"e_1_3_2_2_2","first-page":"S113","volume":"13","year":"1994","unstructured":"Francis GS. 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Magn Reson Q. 1994;10:191\u2013247.","journal-title":"Magn Reson Q"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118528"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00130-8"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)80018-C"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.103.23.2784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T09:21:25Z","timestamp":1715505685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.103.23.2784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,6,12]]},"references-count":12,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2001,6,12]]}},"alternative-id":["10.1161\/01.CIR.103.23.2784"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.103.23.2784","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,6,12]]},"assertion":[{"value":"2001-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-06-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}