Heart Failure With Preserved Ejection Fraction Is Characterized by Dynamic Impairment of Active Relaxation and Contraction of the Left Ventricle on Exercise and Associated With Myocardial Energy Deficiency
Thanh T. Phan, MB, ChB (Hons)*,*,
Khalid Abozguia, MBBCh*,
Ganesh Nallur Shivu, MBBS*,
Gnanadevan Mahadevan, MBBS*,
Ibrar Ahmed, MB, ChB*,
Lynne Williams, MB, ChB*,
Girish Dwivedi, MBBS*,
Kiran Patel, PhD*,
Paul Steendijk, PhD ,
Houman Ashrafian, MA ,
Anke Henning, PhD and
Michael Frenneaux, MD*
* Department of Cardiovascular Medicine, University of Birmingham, Vincent Drive, Edgbaston, Birmingham, United Kingdom
Leiden University Medical Center, Leiden, the Netherlands
Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Figure 1 Impaired Myocardial Energetics in Patients With HFpEF
(A) Cardiac magnetic resonance (MR) images of a patient with heart failure with preserved ejection fraction (HFpEF) and (B) the corresponding localized 31P MR spectra from the left ventricle. The corresponding peaks of creatine phosphate (PCr) and the gamma-, alpha-, and beta-phosphate (resonances of the adenosine triphosphate [ATP]) are labeled. (C) Circles represent individual PCr/gamma-ATP ratio in patients with HFpEF and in control subjects. The subjects PCr/gamma-ATP ratio was significantly reduced in patients with HFpEF compared with healthy control subjects (p = 0.003).
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