Heart failure & cardiomyopathiesMechanistic study
Metabolic flexibility and reverse remodelling of the failing human heart
- Mechanistic study
Authors' conclusion
CRT acutely alters the metabolic phenotype of non-ischaemic cardiomyopathy towards a more physiological picture of FA uptake which correlates with reverse remodelling.
Study context
- Population
- Patients with non-ischaemic cardiomyopathy undergoing cardiac resynchronization therapy (CRT)
- Comparison
- CRT on vs off, with insulin/glucose and intralipid infusions
Main finding
As reported in the abstract
Acute change in stroke work and cardiac substrate uptake with CRT, and correlation with reverse remodelling
- CRT acutely improved stroke work without increasing O2 uptake, on insulin/glucose
- by 34%, P = .05
- CRT acutely improved stroke work without increasing O2 uptake, on intralipid
- by 36%, P = .03
- Increased fatty acid (FA) uptake on insulin/glucose
- R = 0.89, P = .03
- Increased β-hydroxybutyrate uptake during intralipid infusion
- R = 0.81, P = .05
- Reverse remodelling correlated with increased FA uptake with CRT on insulin/glucose
- R = 0.71, P = .05
- Reverse remodelling correlated with increased ketone uptake with CRT on intralipid
- R = 0.79, P = .05
Original publication
Metabolic flexibility and reverse remodelling of the failing human heart. Eur Heart J. Published 25 February 2025. doi:10.1093/eurheartj/ehaf033
Summarised from the published abstract; every number is checked against it