ArticleCirculation2020
Cardiac Energetics in Patients With Aortic Stenosis and Preserved Versus Reduced Ejection Fraction.
Article in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Phosphorus Magnetic Resonance Spectroscopy (Medicina (Kaunas, Lithuania) · 2023Pooled it
- CARDIOKIN1: Computational Assessment of Myocardial Metabolic Capability in Healthy Controls and Patients With Valve Diseases.Circulation · 2021Trial
- Faster and More Robust CK Reaction Rate Estimation at 3T Using Acquisition-WeightedMagnetic resonance in medicine · 2026Article
- Glycoursodeoxycholic acid 3 sulfate sodium links hemodynamics and bile acid metabolism in aortic stenosis.Journal of advanced research · 2026Article
- 20(S)-protopanaxatriol ameliorates cardiac hypertrophy by activating the AMPK/PGC-1α/PPARγ signaling pathway.Journal of ginseng research · 2026Article
- Mitochondrial Resilience: Unraveling the Triadic Interplay of Phosphocreatine, Cyclophilin D, and STAT3 in Heart Failure.Journal of cardiovascular translational research · 2026Review
- A Translational Model of MASLD-Associated HFpEF Defines Mitochondrial Dysfunction and Cardiac Plasticity During Disease Progression and Regression.bioRxiv : the preprint server for biology · 2026Article
- Challenges and opportunities in assessing right ventricular structure and function: a Roadmap for standardization, clinical implementation and research.Nature reviews. Cardiology · 2026Review
- Cardiac energetics in severe mitral regurgitation: relationship with eccentric hypertrophy, stroke volume, and effects of valve repair.European heart journal. Imaging methods and practice · 2025Article
- Pathophysiological insights into HFpEF from studies of human cardiac tissue.Nature reviews. Cardiology · 2025Review
- Maintaining energy provision in the heart: the creatine kinase system in ischaemia-reperfusion injury and chronic heart failure.Clinical science (London, England : 1979) · 2024Review
- Article
- Metabolic Dysfunction in Aortic Stenosis: A Key Piece of the Pathophysiological Puzzle.Circulation. Cardiovascular imaging · 2023Article
- Role of Cardiac Energetics in Aortic Stenosis Disease Progression: Identifying the High-risk Metabolic Phenotype.Circulation. Cardiovascular imaging · 2023Article
- Different heart failure phenotypes of valvular heart disease: the role of mitochondrial dysfunction.Frontiers in cardiovascular medicine · 2023Review
- Insights Into the Metabolic Aspects of Aortic Stenosis With the Use of Magnetic Resonance Imaging.JACC. Cardiovascular imaging · 2022Review
- Myocardial Fatigue: a Mechano-energetic Concept in Heart Failure.Current cardiology reports · 2022Review
- Myocardial inflammation and energetics by cardiac MRI: a review of emerging techniques.BMC medical imaging · 2021Review
- Obesity modifies the energetic phenotype of dilated cardiomyopathy.European heart journal · 2021Article
- Water-suppression cycling 3-T cardiacNMR in biomedicine · 2021Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
16 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundWhy some but not all patients with severe aortic stenosis (SevAS) develop otherwise unexplained reduced systolic function is unclear. We investigate the hypothesis that reduced creatine kinase (CK) capacity and flux is associated with this transition.
methodsWe recruited 102 participants to 5 groups: moderate aortic stenosis (ModAS) (n=13), SevAS, left ventricular (LV) ejection fraction ≥55% (SevAS-preserved ejection fraction, n=37), SevAS, LV ejection fraction <55% (SevAS-reduced ejection fraction, n=15), healthy volunteers with nonhypertrophied hearts with normal systolic function (normal healthy volunteer, n=30), and patients with nonhypertrophied, non-pressure-loaded hearts with normal systolic function undergoing cardiac surgery and donating LV biopsy (non-pressure-loaded heart biopsy, n=7). All underwent cardiac magnetic resonance imaging and
resultsIn the absence of failure, CK flux was lower in the presence of AS (by 32%,
conclusionsTotal CK capacity is reduced in SevAS, with median values lowest in those with systolic failure, consistent with reduced energy supply reserve. Despite this, in vivo magnetic resonance spectroscopy measures of resting CK flux suggest that ATP delivery is reduced earlier, at the moderate AS stage, where LV function remains preserved. These findings show that significant energetic impairment is already established in moderate AS and suggest that a fall in CK flux is not by itself a necessary cause of transition to systolic failure. However, because ATP demands increase with AS severity, this could increase susceptibility to systolic failure. As such, targeting CK capacity and flux may be a therapeutic strategy to prevent and treat systolic failure in AS.
Indexed as
Identifiers
What OpenQuestion holds
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.