Abstract #1087

Creatine kinase energy supply correlates with mechanical work and efficiency in healthy and failing human heart: a combined noninvasive MRI/MRS study

Refaat E Gabr^1,2, AbdEl-Monem M El-Sharkawy^1,3, Michael Schär¹, Gary Gerstenblith⁴, Robert G Weiss⁴, and Paul A Bottomley¹

¹Division of MR Research, Department of Radiology, The Johns Hopkins University, Baltimore, MD, United States, ²Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States, ³Systems and Biomedical Engineering, Faculty of Engineering, Cairo University, Cairo, Egypt, ⁴Department of Cardiology, The Johns Hopkins University, Baltimore, MD, United States

It is hypothesized that chemical energy supply is insufficient to fuel normal mechanical pump function in heart failure (HF). To test whether reduced function correlates with reduced energy supply, we used magnetic resonance spectroscopy and imaging to measure adenosine triphosphate (ATP) synthesis via the creatine kinase reaction–the heart’s primary reserve–and cardiac mechanical stroke work in 14 healthy subjects and 27 patients with mild-to-moderate HF. We found significantly reduced cardiac creatine kinase flux that correlated with peak and average stroke work rates and with mechanical efficiency. These first noninvasive findings are consistent with the energy deprivation hypothesis of HF.

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