Department of Medicine, Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Circ Cardiovasc Imaging. 2011 Jan;4(1):42-50. doi: 10.1161/CIRCIMAGING.110.959320. Epub 2010 Oct 6.
The hypothesis that the failing heart may be energy-starved is supported in part by observations of reduced rates of adenosine 5'-triphosphate (ATP) synthesis through the creatine kinase (CK) reaction, the primary myocardial energy reservoir, in patients with heart failure (HF). Although murine models have been used to probe HF pathophysiology, it has not been possible to noninvasively measure the rate of ATP synthesis through CK in the in vivo mouse heart. The purpose of this work was to exploit noninvasive spatially localized magnetic resonance spectroscopy techniques to measure ATP flux through CK in in vivo mouse hearts and determine the extent of any reductions in murine HF.
The Triple Repetition Time Saturation Transfer (TRiST) magnetic resonance spectroscopy method of measuring ATP kinetics was first validated in skeletal muscle, rendering similar results to conventional saturation transfer magnetic resonance spectroscopy. In normal mouse hearts, the in vivo CK pseudo-first-order-rate constant, k(F), was 0.32±0.03 s(-1) (mean±SD) and the rate of ATP synthesis through CK was 3.16±0.47 μmol/g/s. Thoracic aortic constriction reduced k(F) by 31% (0.23±0.03 s(-1), P<0.0001) and ATP synthesis through CK by 51% (1.54±0.25 μmol/g/s, P<0.0001), values analogous to those in failing human hearts.
Despite the small size and high murine heart rate, the ATP synthesis rate through CK is similar in vivo in murine and human hearts and comparably reduced in HF. Because murine thoracic aortic constriction shares fundamental energetic similarities with human HF, this model and new magnetic resonance spectroscopy approach promise a powerful means to noninvasively probe altered energetics in HF.
衰竭心脏可能能量匮乏的假说部分得到了以下观察结果的支持:心力衰竭(HF)患者的三磷酸腺苷(ATP)通过肌酸激酶(CK)反应的合成率降低,CK 是心肌的主要能量储备。虽然已经使用鼠模型来研究 HF 病理生理学,但无法在体内鼠心脏中无创性地测量 CK 中的 ATP 合成率。本研究旨在利用非侵入性空间局部磁共振波谱技术测量体内鼠心脏中 CK 中的 ATP 通量,并确定 HF 中任何减少的程度。
首先在骨骼肌中验证了测量 ATP 动力学的三重重复时间饱和转移(TRiST)磁共振波谱法,结果与传统的饱和转移磁共振波谱法相似。在正常鼠心脏中,体内 CK 拟一级速率常数 k(F)为 0.32±0.03 s(-1)(平均值±SD),CK 中的 ATP 合成速率为 3.16±0.47 μmol/g/s。胸主动脉缩窄使 k(F)降低 31%(0.23±0.03 s(-1),P<0.0001),CK 中的 ATP 合成降低 51%(1.54±0.25 μmol/g/s,P<0.0001),与衰竭人类心脏中的值相似。
尽管鼠心脏的体积小、心率高,但 CK 中的 ATP 合成率在体内与人类心脏相似,在 HF 中也相似降低。由于鼠胸主动脉缩窄与人类 HF 具有基本的能量相似性,因此该模型和新的磁共振波谱方法有望成为一种强大的手段,可无创性地研究 HF 中的能量代谢改变。