Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging

Pressure overload in aortic stenosis (AS) encompasses both structural and metabolic remodeling and increases the risk of decompensation into heart failure. A major component of metabolic derangement in AS is abnormal cardiac substrate use, with down-regulation of fatty acid oxidation, increased reli...

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Main Authors: Monga, S, Valkovič, L, Tyler, D, Lygate, CA, Rider, O, Myerson, SG, Neubauer, S, Mahmod, M
Format: Journal article
Language:English
Published: Elsevier 2022
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author Monga, S
Valkovič, L
Tyler, D
Lygate, CA
Rider, O
Myerson, SG
Neubauer, S
Mahmod, M
author_facet Monga, S
Valkovič, L
Tyler, D
Lygate, CA
Rider, O
Myerson, SG
Neubauer, S
Mahmod, M
author_sort Monga, S
collection OXFORD
description Pressure overload in aortic stenosis (AS) encompasses both structural and metabolic remodeling and increases the risk of decompensation into heart failure. A major component of metabolic derangement in AS is abnormal cardiac substrate use, with down-regulation of fatty acid oxidation, increased reliance on glucose metabolism, and subsequent myocardial lipid accumulation. These changes are associated with energetic and functional cardiac impairment in AS and can be assessed with the use of cardiac magnetic resonance spectroscopy (MRS). Proton MRS allows the assessment of myocardial triglyceride content and creatine concentration. Phosphorous MRS allows noninvasive in vivo quantification of the phosphocreatine-to-adenosine triphosphate ratio, a measure of cardiac energy status that is reduced in patients with severe AS. This review summarizes the changes to cardiac substrate and high-energy phosphorous metabolism and how they affect cardiac function in AS. The authors focus on the role of MRS to assess these metabolic changes, and potentially guide future (cellular) metabolic therapy in AS.
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spelling oxford-uuid:0bc99f45-3a16-4578-8fde-b0af716345292022-12-21T07:35:55ZInsights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imagingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0bc99f45-3a16-4578-8fde-b0af71634529EnglishSymplectic ElementsElsevier2022Monga, SValkovič, LTyler, DLygate, CARider, OMyerson, SGNeubauer, SMahmod, MPressure overload in aortic stenosis (AS) encompasses both structural and metabolic remodeling and increases the risk of decompensation into heart failure. A major component of metabolic derangement in AS is abnormal cardiac substrate use, with down-regulation of fatty acid oxidation, increased reliance on glucose metabolism, and subsequent myocardial lipid accumulation. These changes are associated with energetic and functional cardiac impairment in AS and can be assessed with the use of cardiac magnetic resonance spectroscopy (MRS). Proton MRS allows the assessment of myocardial triglyceride content and creatine concentration. Phosphorous MRS allows noninvasive in vivo quantification of the phosphocreatine-to-adenosine triphosphate ratio, a measure of cardiac energy status that is reduced in patients with severe AS. This review summarizes the changes to cardiac substrate and high-energy phosphorous metabolism and how they affect cardiac function in AS. The authors focus on the role of MRS to assess these metabolic changes, and potentially guide future (cellular) metabolic therapy in AS.
spellingShingle Monga, S
Valkovič, L
Tyler, D
Lygate, CA
Rider, O
Myerson, SG
Neubauer, S
Mahmod, M
Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title_full Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title_fullStr Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title_full_unstemmed Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title_short Insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
title_sort insights into the metabolic aspects of aortic stenosis with the use of magnetic resonance imaging
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