Heart failure & cardiomyopathies

Quantifying skeletal muscle energy metabolism during exercise in heart failure with preserved ejection fraction using in vivo 31P magnetic resonance spectroscopy

ESC Heart FailPublished parallel analysis of prospective studies

Authors' conclusion

Patients with HFpEF exhibit impaired whole-muscle oxidative capacity of skeletal muscle, as shown by two different 31P-MRS protocols with upper leg measurements, independent of ID status.

Study context

Population
Patients with heart failure and preserved ejection fraction (HFpEF) and control individualsFifty-eight patients with HFpEF and 16 controls · isometric exercise HFpEF 46 · isometric exercise control 16 · cardiopulmonary exercise HFpEF 12
Exposure
Patients with HFpEF and control individuals
  • HFpEFn = Fifty-eight
  • Controln = 16
Outcome
Phosphocreatine recovery halftime after isometric exercise
Methodological detailstwo sites
  • Two sites

Main finding

As reported in the abstract

P = 0.03

Observational data: associations, not effects.

Further findings

Phosphocreatine recovery halftime after dynamic exercise — HFpEF
39 (range as printed 27–57) seconds

Exercise and oxidative muscle capacity, with vs without iron deficiency (ID)

Isometric cohort with and without ID
n = 19 and 27
Cardiopulmonary cohort with and without ID
n = 6 and 6
Comparable exercise and oxidative muscle capacity
all P > .42

High-sensitive C-reactive protein and phosphocreatine recovery halftime

Associated with prolonged phosphocreatine recovery halftime
P = . 01

Original publication

Quantifying skeletal muscle energy metabolism during exercise in heart failure with preserved ejection fraction using in vivo 31P magnetic resonance spectroscopy. ESC Heart Fail. Published 20 January 2026. doi:10.1093/eschf/xvaf035

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