人类心力衰竭的肌肉代谢与保存的喷射分数
Virginia S Hahn1, Christopher Petucci2, Min-Soo Kim2
1Division of Cardiology (V.S.H., S.M., N.K., E.J.Y., D.A.K., K.S.), Johns Hopkins University School of Medicine, Baltimore, MD.
Circulation
|March 1, 2023
概括
即使肥胖和糖尿病,心力衰竭患者的脂肪酸代谢也会降低. 心肌燃料的使用是不灵活的,挑战目前对心力衰竭代谢的理解.
科学领域:
- 心脏病学
- 代谢学
- 生物化学
背景情况:
- 人类的心脏主要使用脂肪酸,但在心力衰竭和减少排泄率 (HFrEF) 的情况下,这种情况会发生变化.
- 在严重肥胖和糖尿病中可能会增加心肌脂肪酸代谢,但其在心力衰竭中所起的作用尚不清楚.
研究的目的:
- 对HFpEF患者的心肌和血代谢物概况进行研究,特别是关于脂肪酸代谢.
- 考虑肥胖和糖尿病,比较HFpEF,HFrEF和非失败对照的代谢概况.
主要方法:
- 从HFpEF,HFrEF和对照组进行了定量向代谢分析.
- 代谢数据与RNA测序相结合,并使用聚类,统计测试和机器学习进行分析.
主要成果:
- 与对照组相比,心肌脂肪酸代谢物 (acylcarnitines) 的HFpEF和HFrEF都较低,尽管HFpEF的肥胖和糖尿病较高.
- 在HFpEF心肌中,酸和三酸循环中间体的含量较高,以及葡萄糖和分支链氨基酸 (BCAA) 的代谢变化.
- 血代谢物水平并不总是反映心肌变化,HFrEF中的含量增加,但HFpEF没有.
结论:
- 即使患有显著的肥胖和糖尿病,HFpEF患者的心肌脂肪酸代谢减少和替代燃料利用受损.
- 这些发现挑战了传统观点,并表明HFpEF的代谢不灵活性很大.
- 心肌代谢变化在HFpEF中并没有完全反映在血概况中.
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