Cardiac work is related to creatine kinase energy supply in human heart failure: a cardiovascular magnetic resonance spectroscopy study
Gabr RE, El-Sharkawy AM, Schär M, Panjrath GS, Gerstenblith G, Weiss RG, Bottomley PA
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 36 citations
How it was studied
- Design
- Case-control study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Nonprofit
- American Heart Association
- Government
- National Institutes of Health
- Government
- National Heart, Lung, and Blood Institute
- Government
- NHLBI NIH HHS
- Grants
- National Heart, Lung, and Blood Institute (R01 HL061912); National Heart, Lung, and Blood Institute (R01 HL61912); American Heart Association (13GRNT17050100); National Institutes of Health (#HL61912); National Institutes of Health (R01 HL61912)
Based on 4 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2018-02-01 · J Cardiovasc Magn Reson · vol. 20 · issue 1 · p. 81
- Publisher
- BioMed Central
- Cited
- 46 citations · more than 91% of similar papers · 2.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 61 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Cardiomyopathy and Myosin Studies · Cardiovascular Function and Risk Factors · Cardiac electrophysiology and arrhythmias
- Keywords
- Angiology, Medicine, Heart failure, Cardiac magnetic resonance, Creatine kinase, Cardiology, Human heart, Magnetic resonance imaging, Internal medicine, Creatine, Work (physics), Nuclear magnetic resonance, Radiology, Mechanical engineering, Engineering, Physics
- MeSH
- myocardium, humans, creatine kinase, adenosine triphosphate, magnetic resonance imaging, cine, stroke volume, magnetic resonance spectroscopy, case-control studies, predictive value of tests, energy metabolism, myocardial contraction, ventricular function, left, adult, middle aged, female, male, heart failure, biomarkers
7 authors
From US, EG
- Refaat E. GabrJohns Hopkins University; The University of Texas Health Science Center at Houston
- AbdEl‐Monem M. El‐SharkawyJohns Hopkins University; Cairo University
- Michael Schär · correspondingJohns Hopkins University
- Gurusher Singh PanjrathJohns Hopkins University; George Washington University; Johns Hopkins Medicine
- Gary GerstenblithJohns Hopkins University; Johns Hopkins Medicine
- Robert George WeissJohns Hopkins University; Johns Hopkins Medicine
Abstract
Background
It has been hypothesized that the supply of chemical energy may be insufficient to fuel normal mechanical pump function in heart failure (HF). The creatine kinase (CK) reaction serves as the heart's primary energy reserve, and the supply of adenosine triphosphate (ATP flux) it provides is reduced in human HF. However, the relationship between the CK energy supply and the mechanical energy expended has never been quantified in the human heart. This study tests whether reduced CK energy supply is associated with reduced mechanical work in HF patients.
Methods
Cardiac mechanical work and CK flux in W/kg, and mechanical efficiency were measured noninvasively at rest using cardiac pressure-volume loops, magnetic resonance imaging and phosphorus spectroscopy in 14 healthy subjects and 27 patients with mild-to-moderate HF.
Results
In HF, the resting CK flux (126 ± 46 vs. 179 ± 50 W/kg, p < 0.002), the average (6.8 ± 3.1 vs. 10.1 ± 1.5 W/kg, p <0.001) and the peak (32 ± 14 vs. 48 ± 8 W/kg, p < 0.001) cardiac mechanical work-rates, as well as the cardiac mechanical efficiency (53% ± 16 vs. 79% ± 3, p < 0.001), were all reduced by a third compared to healthy subjects. In addition, cardiac CK flux correlated with the resting peak and average mechanical power (p < 0.01), and with mechanical efficiency (p = 0.002).
Conclusion
These first noninvasive findings showing that cardiac mechanical work and efficiency in mild-to-moderate human HF decrease proportionately with CK ATP energy supply, are consistent with the energy deprivation hypothesis of HF. CK energy supply exceeds mechanical work at rest but lies within a range that may be limiting with moderate activity, and thus presents a promising target for HF treatment.
Trial registration
ClinicalTrials.gov Identifier: NCT00181259 .
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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