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Development of a point-of-contact technique to measure adenosine triphosphate: A quality improvement study.

ABSTRACT: Purpose:Patients with heart failure with preserved ejection fraction (HFpEF) experience fatigue due to impaired myocardial bioenergetics. Cardiomyocyte function depends on the delivery of adenosine triphosphate (ATP), yet there is no convenient bedside method to measure ATP. The purpose of this study was to develop a point-of-contact measurement of ATP that can be used in a clinical setting. Methods:In a laboratory setting, digital finger punctures were conducted using 5??l and 10??l of capillary blood placed into various amounts of water (H2O). After mixing the solution for 10?s, a Hygiena AquaSnapTM Free ATP probe was placed into the solution for 10?s for the detection of ATP. The probe was then placed into the Hygiena luminometer for 15?s, and a value in relative light units (RLU) was obtained. Results:Test samples using 10??l of blood diluted from 50 to 500?mls of H2O produced ATP readings of 10,000-7569 RLUs. Using 5??l of blood in 375-900?ml of H2O decreased the ATP values to 6459-4189 RLUs. Dilutional volume sparing experiments were conducted with ATP standards to determine the concentration of ATP per RLUs. Conclusion:Patients with HFpEF have increased metabolic demand and impaired myocardial bioenergetics. Thus, identifying a method to measure ATP that is quick and accurate is imperative to accurately assess cellular energy production in this population. Point-of-contact measures, such as ATP, are needed for precision-guided treatment. Data from this study provides the first step toward developing evidence for health policies related to managing fatigue.

SUBMITTER: Pierce J

PROVIDER: S-EPMC6462498 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Development of a point-of-contact technique to measure adenosine triphosphate: A quality improvement study.

Pierce Janet J Hiebert John B JB Mahoney Diane D Shen Qiuhua Q Peltzer Jill J Rahman Faith F Johnson Samantha S Pierce John T JT

Annals of medicine and surgery (2012) 20190405

<h4>Purpose</h4>Patients with heart failure with preserved ejection fraction (HFpEF) experience fatigue due to impaired myocardial bioenergetics. Cardiomyocyte function depends on the delivery of adenosine triphosphate (ATP), yet there is no convenient bedside method to measure ATP. The purpose of this study was to develop a point-of-contact measurement of ATP that can be used in a clinical setting.<h4>Methods</h4>In a laboratory setting, digital finger punctures were conducted using 5 μl and 10 ...[more]

PMID: 31011421

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Project description:BackgroundDeep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for disabling fluctuations in motor symptoms in Parkinson's disease (PD) patients. However, iterative exploration of all individual contact points (four in each STN) by the clinician for optimal clinical effects may take months.ObjectiveIn this proof of concept study we explored whether magnetoencephalography (MEG) has the potential to noninvasively measure the effects of changing the active contact point of STN-DBS on spectral power and functional connectivity in PD patients, with the ultimate aim to aid in the process of selecting the optimal contact point, and perhaps reduce the time to achieve optimal stimulation settings.MethodsThe study included 30 PD patients who had undergone bilateral DBS of the STN. MEG was recorded during stimulation of each of the eight contact points separately (four on each side). Each stimulation position was projected on a vector running through the longitudinal axis of the STN, leading to one scalar value indicating a more dorsolateral or ventromedial contact point position. Using linear mixed models, the stimulation positions were correlated with band-specific absolute spectral power and functional connectivity of i) the motor cortex ipsilateral tot the stimulated side, ii) the whole brain.ResultsAt group level, more dorsolateral stimulation was associated with lower low-beta absolute band power in the ipsilateral motor cortex (p = .019). More ventromedial stimulation was associated with higher whole-brain absolute delta (p = .001) and theta (p = .005) power, as well as higher whole-brain theta band functional connectivity (p = .040). At the level of the individual patient, switching the active contact point caused significant changes in spectral power, but the results were highly variable.ConclusionsWe demonstrate for the first time that stimulation of the dorsolateral (motor) STN in PD patients is associated with lower low-beta power values in the motor cortex. Furthermore, our group-level data show that the location of the active contact point correlates with whole-brain brain activity and connectivity. As results in individual patients were quite variable, it remains unclear if MEG is useful in the selection of the optimal DBS contact point.

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Development of a point-of-contact technique to measure adenosine triphosphate: A quality improvement study.

Publications

Development of a point-of-contact technique to measure adenosine triphosphate: A quality improvement study.

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