Metabolic Response of the Immature Right Ventricle to Acute Pressure Overloading

Journal of the American Heart Association
Masaki KajimotoMichael A Portman

Abstract

Surgical palliation or repair of complex congenital heart disease in early infancy can produce right ventricular (RV) pressure overload, often leading to acute hemodynamic decompensation. The mechanisms causing this acute RV dysfunction remain unclear. We tested the hypothesis that the immature right ventricle lacks the ability to modify substrate metabolism in order to meet increased energy demands induced by acute pressure overloading. Twenty-two infant male mixed breed Yorkshire piglets were randomized to a sham operation (Control) or pulmonary artery banding yielding >2-fold elevation over baseline RV systolic pressure. We used carbon 13 (13C)-labeled substrates and proton nuclear magnetic resonance to assess RV energy metabolism. [Phosphocreatine]/[ATP] was significantly lower after pulmonary artery banding. [Phosphocreatine]/[ATP] inversely correlated with energy demand indexed by maximal sustained RV systolic pressure/left ventricular systolic pressure. Fractional contributions of fatty acids to citric acid cycle were significantly lower in the pulmonary artery banding group than in the Control group (medium-chain fatty acids; 14.5±1.6 versus 8.2±1.0%, long-chain fatty acids; 9.3±1.5 versus 5.1±1.1%). 13C-flux analysis s...Continue Reading

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Citations

Sep 22, 2018·American Journal of Physiology. Heart and Circulatory Physiology·Matthew D Files, Bhawna Arya
Feb 29, 2020·American Journal of Physiology. Heart and Circulatory Physiology·Anastacia M GarciaStephanie J Nakano
Aug 28, 2019·Journal of the American Heart Association·Masaki KajimotoMichael A Portman
Mar 20, 2021·Frontiers in Physiology·Kathleen C Woulfe, Lori A Walker

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Methods Mentioned

BETA
nuclear magnetic resonance
NMR
protein assay

Software Mentioned

NUTS
Chenomx
VNMRJ
TCAcalc
Image J

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