Dataset Information

Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure.

ABSTRACT:

Background

Myocardial oxygen consumption (MVO₂) and its coupling to contractile work are fundamentals of cardiac function and may be involved causally in the transition from compensated left ventricular hypertrophy to failure. Nevertheless, these processes have not been studied previously in patients with aortic valve stenosis (AS).

Methods and results

Participants underwent ¹¹C-acetate positron emission tomography, cardiovascular magnetic resonance, and echocardiography to measure MVO₂ and myocardial external efficiency (MEE) defined as the ratio of left ventricular stroke work and the energy equivalent of MVO₂. We studied 10 healthy controls (group A), 37 asymptomatic AS patients with left ventricular ejection fraction ?50% (group B), 12 symptomatic AS patients with left ventricular ejection fraction ?50% (group C), and 9 symptomatic AS patients with left ventricular ejection fraction <50% (group D). MVO₂ did not differ among groups A, B, C, and D (0.105±0.02, 0.117±0.024, 0.129±0.032, and 0.104±0.026 mL/min per gram, respectively; P=0.07), whereas MEE was reduced in group D (21.0±1.6%, 22.3±3.3%, 22.1±4.2%, and 17.3±4.7%, respectively; P<0.05). Similarly, patients with global longitudinal strain greater than -12% and paradoxical low-flow, low-gradient AS had impaired MEE (P<0.05 versus controls). The ability to discriminate between symptomatic and asymptomatic patients was superior for global longitudinal strain compared with MVO₂ and MEE (area under the curve 0.98, 0.48, and 0.61, respectively; P<0.05).

Conclusions

AS patients display a persistent ability to maintain normal MVO₂ and MEE (ie, the ability to convert energy into stroke work); however, patients with left ventricular ejection fraction <50%; global longitudinal strain greater than -12%; or paradoxical low-flow, low-gradient AS demonstrate reduced MEE. These findings suggest that mitochondrial uncoupling contributes to the dismal prognosis in patients with reduced contractile function or paradoxical low-flow, low-gradient AS.

SUBMITTER: Hansson NH

PROVIDER: S-EPMC5523773 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Publications

Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure.

Hansson Nils Henrik Stubkjær NH Sörensen Jens J Harms Hendrik Johannes HJ Kim Won Yong WY Nielsen Roni R Tolbod Lars P LP Frøkiær Jørgen J Bouchelouche Kirsten K Dodt Karen Kaae KK Sihm Inger I Poulsen Steen Hvitfeldt SH Wiggers Henrik H

Journal of the American Heart Association 20170206 2

<h4>Background</h4>Myocardial oxygen consumption (MVO<sub>2</sub>) and its coupling to contractile work are fundamentals of cardiac function and may be involved causally in the transition from compensated left ventricular hypertrophy to failure. Nevertheless, these processes have not been studied previously in patients with aortic valve stenosis (AS).<h4>Methods and results</h4>Participants underwent <sup>11</sup>C-acetate positron emission tomography, cardiovascular magnetic resonance, and echo ...[more]

PMID: 28167498

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Dataset Information

Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure.

Background

Methods and results

Conclusions

Publications

Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure.

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