Myocardial efficiency in patients with different aetiologies and stages of heart failure.

Autor:	Hansen KB; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark., Sörensen J; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark.; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus N, Denmark.; Department of Surgical Sciences, Nuclear Medicine, Uppsala University, Uppsala, Sweden., Hansson NH; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark., Nielsen R; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark., Larsen AH; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark., Frøkiær J; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark., Tolbod LP; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus N, Denmark., Gormsen LC; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark.; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus N, Denmark., Harms HJ; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus N, Denmark., Wiggers H; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2022 Feb 22; Vol. 23 (3), pp. 328-337.
DOI:	10.1093/ehjci/jeab227
Abstrakt:	Aims: Myocardial external efficiency (MEE) is the ratio of cardiac work in relation with energy expenditure. We studied MEE in patients with different aetiologies and stages of heart failure (HF) to discover the role and causes of deranged MEE. In addition, we explored the impact of patient characteristics such as sex, body mass index (BMI), and age on myocardial energetics. Methods and Results: Cardiac energetic profiles were assessed with 11C-acetate positron emission tomography (PET) and left ventricular ejection fraction (LVEF) was acquired with echocardiography. MEE was studied in 121 participants: healthy controls (n = 20); HF patients with reduced (HFrEF; n = 25) and mildly reduced (HFmrEF; n = 23) LVEF; and patients with asymptomatic (AS-asymp; n = 38) and symptomatic (AS-symp; n = 15) aortic stenosis (AS). Reduced MEE coincided with symptoms of HF irrespective of aetiology and declined in tandem with deteriorating LVEF. Patients with AS-symp and HFmrEF had reduced MEE as compared with controls (22.2 ± 4.9%, P = 0.041 and 20.0 ± 4.2%, P < 0.001 vs. 26.1 ± 5.8% in controls) and a further decline was observed in patients with HFrEF (14.7 ± 6.3%, P < 0.001). Disproportionate left ventricular hypertrophy was a major cause of reduced MEE. Female sex (P < 0.001), a lower BMI (P = 0.001), and advanced age (P = 0.03) were associated with a lower MEE. Conclusion: MEE was reduced in patients with HFrEF, HFmrEF, and HF due to pressure overload and MEE may therefore constitute a treatment target in HF. Patients with LVH, advanced age, female sex, and low BMI had more pronounced reduction in MEE and personalized treatment within these patient subgroups could be relevant. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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