What is the clinical evidence from this study?

Study design: Observational. Population: Heart failure (n=41). Intervention: Heart failure (disease state) vs. Healthy subjects. Primary outcome: Resting creatine kinase (CK) flux (W/kg) (p=<0.002).

What does this research mean for the field?

In patients with mild-to-moderate heart failure, resting creatine kinase flux is significantly reduced by 32% compared to healthy subjects, and this reduction correlates proportionately with decreased cardiac mechanical work and efficiency. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

February 1, 2018Journal of Cardiovascular Magnetic ResonanceOpen Access

Cardiac work is related to creatine kinase energy supply in human heart failure: a cardiovascular magnetic resonance spectroscopy study

Q: What are the key findings of this study?

In patients with mild-to-moderate heart failure, resting creatine kinase flux was significantly reduced by 32% (126 vs. 179 W/kg) compared to healthy subjects, correlating with reduced mechanical work.

Q: What does this research mean for the field?

In patients with mild-to-moderate heart failure, resting creatine kinase flux is significantly reduced by 32% compared to healthy subjects, and this reduction correlates proportionately with decreased cardiac mechanical work and efficiency. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

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Key result

In patients with mild-to-moderate heart failure, resting creatine kinase flux was significantly reduced by 32% (126 vs. 179 W/kg) compared to healthy subjects, correlating with reduced mechanical work.

Why the study?

Is reduced creatine kinase energy supply associated with reduced mechanical work in patients with mild-to-moderate heart failure?

Population

41 adults. Conducted at Johns Hopkins University. Key exclusions: contraindications to CMR, significant…

Design

Cross-sectional

Authors

RGRefaat E. GabrBiogen (United States)AEAbdEl‐Monem M. El‐SharkawyCairo University MSMichael SchärUniversity of Bern

Discussion

Member takes

Implication

Supports energy deprivation hypothesis in mild-to-moderate HF; leaves open whether CK flux is a modifiable therapeutic target.

Study Design

Type

Observational (n=41)

Multicenter

Structured PICO

Is reduced creatine kinase energy supply associated with reduced mechanical work in patients with mild-to-moderate heart failure?

Population

41 adults (27 patients with mild-to-moderate nonischemic heart failure, NYHA class I-III, LVEF ≤45%, mean age 45 ± 14 years; and 14 age-matched healthy subjects, mean age 42 ± 18 years). Conducted at Johns Hopkins University (US). Key exclusions: contraindications to CMR, significant valvular disease, or critical coronary disease.

Comparator

Healthy age-matched subjects with no history of heart disease, diabetes, or hypertension

Outcome

Cardiac mechanical work (average and peak mechanical power), mechanical efficiency, and creatine kinase (CK) flux measured noninvasively at restsurrogate

Main Result

Absolute Event Rate: 126% vs 179%

p-value: p=<0.002

In patients with mild-to-moderate nonischemic heart failure, cardiac mechanical work and efficiency decrease proportionately with creatine kinase ATP energy supply, supporting the energy deprivation hypothesis of heart failure.

Limitations

Left ventricular chamber pressure was approximated from brachial arterial blood pressure rather than measured via invasive catheterization.
Assumption of totally unstressed volume V0 = 0 for potential energy estimation.
The cohort had less severe heart failure, so findings may not generalize to more severe or other forms of heart failure.
Lack of creatine kinase flux measurements during stress or exercise.
Obtaining LV pressure from brachial artery pressure is potentially confounding
Assumption of unstressed volume V0 = 0
Patients had less severe HF, so findings may not apply to severe HF
Cohort limited to non-ischemic cardiomyopathy

Cite This Study

Gabr et al. (2018) conducted an observational in Heart failure (n=41). Heart failure (disease state) vs. Healthy subjects was evaluated on Resting creatine kinase (CK) flux (W/kg) (p=<0.002). In patients with mild-to-moderate heart failure, resting creatine kinase flux was significantly reduced by 32% (126 vs. 179 W/kg) compared to healthy subjects, correlating with reduced mechanical work.

synapsesocial.com/papers/6a15da2d1362a77db8e3c500 https://doi.org/10.1186/s12968-018-0491-6

Topics

HFrEF treatment Heart failure Cardiac MRI

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February 1, 2018Journal of Cardiovascular Magnetic ResonanceOpen Access

Cardiac work is related to creatine kinase energy supply in human heart failure: a cardiovascular magnetic resonance spectroscopy study

View Full Paper

Ask AI

Bookmark

Key result

Why the study?

Is reduced creatine kinase energy supply associated with reduced mechanical work in patients with mild-to-moderate heart failure?

Population

41 adults. Conducted at Johns Hopkins University. Key exclusions: contraindications to CMR, significant…

Design

Cross-sectional

Authors

RGRefaat E. GabrBiogen (United States)AEAbdEl‐Monem M. El‐SharkawyCairo University MSMichael SchärUniversity of Bern

Discussion

Member takes

Implication

Supports energy deprivation hypothesis in mild-to-moderate HF; leaves open whether CK flux is a modifiable therapeutic target.

Study Design

Type

Observational (n=41)

Multicenter

Structured PICO

Is reduced creatine kinase energy supply associated with reduced mechanical work in patients with mild-to-moderate heart failure?

Population

Comparator

Healthy age-matched subjects with no history of heart disease, diabetes, or hypertension

Outcome

Cardiac mechanical work (average and peak mechanical power), mechanical efficiency, and creatine kinase (CK) flux measured noninvasively at restsurrogate

Main Result

Absolute Event Rate: 126% vs 179%

p-value: p=<0.002

Limitations

Left ventricular chamber pressure was approximated from brachial arterial blood pressure rather than measured via invasive catheterization.
Assumption of totally unstressed volume V0 = 0 for potential energy estimation.
The cohort had less severe heart failure, so findings may not generalize to more severe or other forms of heart failure.
Lack of creatine kinase flux measurements during stress or exercise.
Obtaining LV pressure from brachial artery pressure is potentially confounding
Assumption of unstressed volume V0 = 0
Patients had less severe HF, so findings may not apply to severe HF
Cohort limited to non-ischemic cardiomyopathy

Cite This Study

synapsesocial.com/papers/6a15da2d1362a77db8e3c500 https://doi.org/10.1186/s12968-018-0491-6

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

HFrEF treatment Heart failure Cardiac MRI

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