ARTICLE: Energetic Basis of Recovered Ejection Fraction in Human Heart Failure
AUTHORS: Joseph R Goldenberg, Allison G Hays, Refaat E Gabr, Michael Schӓr, T Jake Samuel, Lisa R Yanek, Gary Gerstenblith, Paul A Bottomley, Robert G Weiss
JOURNAL: Circulation. 2023 Dec 12;148(24):1976-1978. doi: 10.1161/CIRCULATIONAHA.123.065217. Epub 2023 Dec 11.
In recent American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines,1 improvement of left ventricular (LV) ejection fraction (LVEF) in patients with heart failure with reduced ejection fraction (HFrEF)2 has been classified as heart failure with improved ejection fraction (HFimpEF). HFimpEF is associated with better long-term outcomes than HFrEF but is difficult to predict, and the underlying mechanisms remain poorly understood. Because LVEF recovery is more common in patients with HFrEF who experience amelioration of adverse energetic conditions, such as those with tachyarrhythmias or thyroid disease,2 and because restoring the primary cardiac energy reserve reaction, creatine kinase (CK), in experimental HFrEF increases LVEF and attenuates pathological remodeling, we hypothesized that better myocardial high-energy phosphate metabolism at baseline predicts the likelihood of future LVEF recovery in a general HFrEF population.
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