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Left ventricular assist device effects on metabolic substrates in the failing heart.

Publication ,  Journal Article
Weitzel, LB; Ambardekar, AV; Brieke, A; Cleveland, JC; Serkova, NJ; Wischmeyer, PE; Lowes, BD
Published in: PLoS One
2013

BACKGROUND: Heart failure patients have inadequate nutritional intake and alterations in metabolism contributing to an overall energy depleted state. Left ventricular assist device (LVAD) support is a common and successful intervention in patients with end-stage heart failure. LVAD support leads to alterations in cardiac output, functional status, neurohormonal activity and transcriptional profiles but the effects of LVADs on myocardial metabolism are unknown. This study set out to measure cardiac metabolites in non-failing hearts, failing hearts, and hearts post-LVAD support. METHODS: The study population consisted of 8 non-ischemic failing (at LVAD implant) and 8 post-LVAD hearts, plus 8 non-failing hearts obtained from the tissue bank at the University of Colorado. NMR spectroscopy was utilized to evaluate differences in myocardial energy substrates. Paired and non-paired t-tests were used to determine differences between the appropriate groups. RESULTS: Glucose and lactate values both decreased from non-failing to failing hearts and increased again significantly in the (paired) post-LVAD hearts. Glutamine, alanine, and aromatic amino acids decreased from non-failing to failing hearts and did not change significantly post-LVAD. Total creatine and succinate decreased from non-failing to failing hearts and did not change significantly post-LVAD. DISCUSSION: Measured metabolites related to glucose metabolism are diminished in failing hearts, but recovered their values post-LVAD. This differed from the amino acid levels, which decreased in heart failure but did not recover following LVAD. Creatine and the citric acid cycle intermediate succinate followed a similar pattern as the amino acid levels.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2013

Volume

8

Issue

4

Start / End Page

e60292

Location

United States

Related Subject Headings

  • Succinic Acid
  • Myocardium
  • Middle Aged
  • Male
  • Lactic Acid
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Glutamine
  • Glucose
 

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Weitzel, L. B., Ambardekar, A. V., Brieke, A., Cleveland, J. C., Serkova, N. J., Wischmeyer, P. E., & Lowes, B. D. (2013). Left ventricular assist device effects on metabolic substrates in the failing heart. PLoS One, 8(4), e60292. https://doi.org/10.1371/journal.pone.0060292
Weitzel, Lindsay B., Amrut V. Ambardekar, Andreas Brieke, Joseph C. Cleveland, Natalie J. Serkova, Paul E. Wischmeyer, and Brian D. Lowes. “Left ventricular assist device effects on metabolic substrates in the failing heart.PLoS One 8, no. 4 (2013): e60292. https://doi.org/10.1371/journal.pone.0060292.
Weitzel LB, Ambardekar AV, Brieke A, Cleveland JC, Serkova NJ, Wischmeyer PE, et al. Left ventricular assist device effects on metabolic substrates in the failing heart. PLoS One. 2013;8(4):e60292.
Weitzel, Lindsay B., et al. “Left ventricular assist device effects on metabolic substrates in the failing heart.PLoS One, vol. 8, no. 4, 2013, p. e60292. Pubmed, doi:10.1371/journal.pone.0060292.
Weitzel LB, Ambardekar AV, Brieke A, Cleveland JC, Serkova NJ, Wischmeyer PE, Lowes BD. Left ventricular assist device effects on metabolic substrates in the failing heart. PLoS One. 2013;8(4):e60292.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2013

Volume

8

Issue

4

Start / End Page

e60292

Location

United States

Related Subject Headings

  • Succinic Acid
  • Myocardium
  • Middle Aged
  • Male
  • Lactic Acid
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Glutamine
  • Glucose