The dissertation is concerned to in vivo phosphorus MR spectroscopy (31 P MRS) and 1 H MR imaging (MRI) of muscle in combination with physical workload. The theoretical part of the thesis describes methodology of 31 P MRS measurement and its clinical use in research of metabolic changes in diabetes, heart failure and peripheral artery disease (PAD). The results of the thesis are divided into methodical and clinical parts. Methodical results deal with the construction of experimental equipment, software modification and development, and show of the reproducibility of the dynamic 31 P MRS. The MRI after exercise was used to the describe involvement of the individual calf muscles to muscle contraction during pedal movement in MR compatible ergometer. The first part of the clinical results of the thesis describes changes in muscle metabolism during diabetes and critical ischemia. In patients with critical ischemia the effect of treatment by angioplasty or transplantation of mesenchymal stem cells was evaluated. In the second part of the clinical results the metabolism of patients with heart failure complicated by sideropenia was studied. In these patients the effect of experimental treatment by iron carboxymaltose was described.

The purpose of this experiment was to investigate skeletal muscle blood flow and glucose uptake in m. biceps (BF) and m. quadriceps femoris (QF) 1) during recovery from high intensity cycle exercise, and 2) while wearing a compression short applying ~37 mmHg to the thigh muscles. Blood flow and glucose uptake were measured in the compressed and non-compressed leg of 6 healthy men by using positron emission tomography. At baseline blood flow in QF (P = 0.79) and BF (P = 0.90) did not differ between the compressed and the non-compressed leg. During recovery muscle blood flow was higher compared to baseline in both compressed (P&lt;0.01) and non-compressed QF (P&lt;0.001) but not in compressed (P = 0.41) and non-compressed BF (P = 0.05; effect size = 2.74). During recovery blood flow was lower in compressed QF (P&lt;0.01) but not in BF (P = 0.26) compared to the non-compressed muscles. During baseline and recovery no differences in blood flow were detected between the superficial and deep parts of QF in both, compressed (baseline P = 0.79; recovery P = 0.68) and non-compressed leg (baseline P = 0.64; recovery P = 0.06). During recovery glucose uptake was higher in QF compared to BF in both conditions (P&lt;0.01) with no difference between the compressed and non-compressed thigh. Glucose uptake was higher in the deep compared to the superficial parts of QF (compression leg P = 0.02). These results demonstrate that wearing compression shorts with ~37 mmHg of external pressure reduces blood flow both in the deep and superficial regions of muscle tissue during recovery from high intensity exercise but does not affect glucose uptake in BF and QF. © 2013 Sperlich et al. / <p>:doi 10.1371/journal.pone.0060923</p>