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Bioenergetic consequences of left ventricular remodeling
1Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.
Circulation
|August 15, 1995
Summary
Altered myocardial high-energy phosphate levels correlate with left ventricular (LV) remodeling. In remodeled hearts, pacing worsens subendocardial phosphate levels, linked to dysfunction and blood flow redistribution.
Area of Science:
- Cardiology
- Biochemistry
- Medical Imaging
Background:
- Left ventricular (LV) remodeling is linked to dysfunction and reduced coronary flow reserve.
- Mechanisms behind these alterations, particularly involving myocardial high-energy phosphates, remain unclear.
Purpose of the Study:
- To investigate the relationship between myocardial high-energy phosphate levels and left ventricular remodeling.
- To explore the impact of pacing on these phosphate levels in remodeled hearts.
Main Methods:
- Magnetic resonance imaging (MRI) assessed LV mass and volume in dogs with induced LV remodeling.
- 31P magnetic resonance spectroscopy (MRS) measured transmural high-energy phosphate levels.
- Blood flow was measured using microspheres during basal conditions and pacing.
Main Results:
- Remodeled LV showed increased mass and volume, with lower subendocardial creatine phosphate (CP)/ATP ratios.
- Subendocardial CP/ATP ratios correlated inversely with LV remodeling extent.
- Pacing in remodeled hearts reduced subendocardial blood flow and CP/ATP levels, increasing end-diastolic pressure.
Conclusions:
- Myocardial high-energy phosphate alterations correlate with LV remodeling severity.
- Pacing-induced tachycardia exacerbates subendocardial phosphate depletion in remodeled hearts, associated with dysfunction and altered blood flow distribution.
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