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We are grateful to Petersen et al for their letter dealing with relevant concerns about left ventricular (LV) energy metabolism and myocardial fibrosis. Based on their previous experiments in rats with myocardial infarction (MI) induced by coronary ligation1 and on their unpublished data, Petersen et al strongly emphasise the fact that our correlative finding between the extension of late enhancement (LE) and the LV phosphocreatine (PCr)/ATP ratio in humans with hypertrophic cardiomyopathy (HCM)2 may not have a causative relationship. We have a few …