Evidence map›Paper›PMID 30526611›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2018

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

Refaat E Gabr, AbdEl-Monem M El-Sharkawy, Michael Schär, Gurusher S Panjrath, Gary Gerstenblith, Robert G Weiss, Paul A Bottomley

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00181259 (In Vivo Cardiac Metabolism in Normal, Ischemic, and Cardiomyopathic Patients During Rest and Stress), which is not on this map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00181259 recruitingnot on this map

In Vivo Cardiac Metabolism in Normal, Ischemic, and Cardiomyopathic Patients During Rest and Stress

TypeobservationalSponsorJohns Hopkins UniversityRan1988 to 2028Enrolled500ConditionsHeart Failure, Congestive
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.

  1. Phosphorus Magnetic Resonance Spectroscopy (Medicina (Kaunas, Lithuania) · 2023
    Pooled it
  2. Article
  3. Mechano-energetic uncoupling in heart failure.Nature reviews. Cardiology · 2025
    Review
  4. Imaging of metabolic dysfunction in genetic cardiomyopathies.The international journal of cardiovascular imaging · 2025
    Review
  5. Review
  6. Review
  7. Human cardiac metabolism.Cell metabolism · 2024
    Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Creatine deficiency and heart failure.Heart failure reviews · 2022
    Review
  18. Observational
  19. Highlights of the Virtual Society for Cardiovascular Magnetic Resonance 2022 Scientific Conference: CMR: improving cardiovascular care around the world.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Refaat E GabrDivision of MR Research, Department of Radiology, The Johns Hopkins University, Park Building, 600 N Wolfe St, Baltimore, MD 21287, USA.
AbdEl-Monem M El-SharkawyDivision of MR Research, Department of Radiology, The Johns Hopkins University, Park Building, 600 N Wolfe St, Baltimore, MD 21287, USA.
Michael SchärDivision of MR Research, Department of Radiology, The Johns Hopkins University, Park Building, 600 N Wolfe St, Baltimore, MD 21287, USA. michael.schar@gmail.com.ORCID 0000-0002-7044-9941
Gurusher S PanjrathDivision of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Gary GerstenblithDivision of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Robert G WeissDivision of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Paul A BottomleyDivision of MR Research, Department of Radiology, The Johns Hopkins University, Park Building, 600 N Wolfe St, Baltimore, MD 21287, USA.
Johns Hopkins University · US

Funding

CONTRIBUTION OF ENERGY DEPLETION TO HUMAN HEART FAILURER01HL061912 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI WEISS, ROBERT G · 1999 to 2020
$8.0M
NHLBI NIH HHS R01 HL061912NHLBI NIH HHS R01 HL61912
6 · The paper itself

Abstract

backgroundIt has been hypothesized that the supply of chemical energy may be insufficient to fuel normal mechanical pump function in heart failure (HF). The creatine kinase (CK) reaction serves as the heart's primary energy reserve, and the supply of adenosine triphosphate (ATP flux) it provides is reduced in human HF. However, the relationship between the CK energy supply and the mechanical energy expended has never been quantified in the human heart. This study tests whether reduced CK energy supply is associated with reduced mechanical work in HF patients.

methodsCardiac mechanical work and CK flux in W/kg, and mechanical efficiency were measured noninvasively at rest using cardiac pressure-volume loops, magnetic resonance imaging and phosphorus spectroscopy in 14 healthy subjects and 27 patients with mild-to-moderate HF.

resultsIn HF, the resting CK flux (126 ± 46 vs. 179 ± 50 W/kg, p < 0.002), the average (6.8 ± 3.1 vs. 10.1 ± 1.5 W/kg, p  <0.001) and the peak (32 ± 14 vs. 48 ± 8 W/kg, p < 0.001) cardiac mechanical work-rates, as well as the cardiac mechanical efficiency (53% ± 16 vs. 79% ± 3, p < 0.001), were all reduced by a third compared to healthy subjects. In addition, cardiac CK flux correlated with the resting peak and average mechanical power (p < 0.01), and with mechanical efficiency (p = 0.002).

conclusionThese first noninvasive findings showing that cardiac mechanical work and efficiency in mild-to-moderate human HF decrease proportionately with CK ATP energy supply, are consistent with the energy deprivation hypothesis of HF. CK energy supply exceeds mechanical work at rest but lies within a range that may be limiting with moderate activity, and thus presents a promising target for HF treatment.

trial registrationClinicalTrials.gov Identifier: NCT00181259 .

Indexed as

Energy MetabolismMyocardial ContractionVentricular Function, LeftAdenosine TriphosphateAdultBiomarkersCase-Control StudiesCreatine KinaseFemaleHeart FailureHumansMagnetic Resonance Imaging, CineMagnetic Resonance SpectroscopyMaleMiddle AgedMyocardiumAdenosine TriphosphateBiomarkersCreatine KinaseCardiac metabolismCardiac workHeart failureMagnetic resonanceTranslational studies

Identifiers

PMID30526611
PMCPMC6287363
OpenAlexW2903105253

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.