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

<h4>Background</h4>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. LVA...

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Autores principales:	Lindsay B Weitzel, Amrut V Ambardekar, Andreas Brieke, Joseph C Cleveland, Natalie J Serkova, Paul E Wischmeyer, Brian D Lowes
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6d9afa7d468840c5986503ef8c78cafd
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spelling	oai:doaj.org-article:6d9afa7d468840c5986503ef8c78cafd2021-11-18T07:51:12ZLeft ventricular assist device effects on metabolic substrates in the failing heart.1932-620310.1371/journal.pone.0060292https://doaj.org/article/6d9afa7d468840c5986503ef8c78cafd2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23560088/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Discussion</h4>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.Lindsay B WeitzelAmrut V AmbardekarAndreas BriekeJoseph C ClevelandNatalie J SerkovaPaul E WischmeyerBrian D LowesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 4, p e60292 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lindsay B Weitzel Amrut V Ambardekar Andreas Brieke Joseph C Cleveland Natalie J Serkova Paul E Wischmeyer Brian D Lowes Left ventricular assist device effects on metabolic substrates in the failing heart.
description	<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Discussion</h4>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.
format	article
author	Lindsay B Weitzel Amrut V Ambardekar Andreas Brieke Joseph C Cleveland Natalie J Serkova Paul E Wischmeyer Brian D Lowes
author_facet	Lindsay B Weitzel Amrut V Ambardekar Andreas Brieke Joseph C Cleveland Natalie J Serkova Paul E Wischmeyer Brian D Lowes
author_sort	Lindsay B Weitzel
title	Left ventricular assist device effects on metabolic substrates in the failing heart.
title_short	Left ventricular assist device effects on metabolic substrates in the failing heart.
title_full	Left ventricular assist device effects on metabolic substrates in the failing heart.
title_fullStr	Left ventricular assist device effects on metabolic substrates in the failing heart.
title_full_unstemmed	Left ventricular assist device effects on metabolic substrates in the failing heart.
title_sort	left ventricular assist device effects on metabolic substrates in the failing heart.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/6d9afa7d468840c5986503ef8c78cafd
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Left ventricular assist device effects on metabolic substrates in the failing heart.

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