Abstract 16290: Heart Failure Metabolomics by Nuclear Magnetic Resonance and the Effects of Ventricular Assist Devices
Background: Nuclear magnetic resonance (NMR) spectroscopy allows for the quantification of large numbers of metabolites in small tissue samples. Little is known about the effects of ventricular assist devices (VADs) on myocardial metabolism. This study investigates the metabolomics of heart failure before and after VAD implantation.
Methods: The study population consisted of 8 non-failing, 8 failing (at VAD implant) and 8 post-VAD human hearts obtained from the tissue bank at the University of Colorado. NMR spectroscopy was utilized to evaluate differences in myocardial energy substrates.
Results: The non-failing hearts had a mean age of 48±8 years with a mean LVEF of 74.5±5%. The failing hearts had a mean age of 40.5±11 years with a mean LVEF of 10±1% which improved to 25.6 ±11% post-VAD. The mean duration of VAD support was 143±41 days. The table lists metabolite differences between non-failing and failing hearts (*=p<.05) and failing and post-VAD hearts. [graph 1]
Conclusions: NMR spectroscopy allows for “omic” measurement of myocardial energy substrates. End-stage heart failure is an energy deprived state with broad abnormalities in glucose, amino acid, and fatty acids concentrations. The pressure and volume unloading of the heart during VAD support appears to normalize glycolytic metabolism, but abnormalities in amino acid and lipid substrates persist. This suggests that some metabolic abnormalities may have a key role in the pathogenesis of heart failure.
- © 2011 by American Heart Association, Inc.