Sex affects myocardial blood flow and fatty acid substrate metabolism in humans with nonischemic heart failure.
Sex affects myocardial blood flow and fatty acid substrate metabolism in humans with nonischemic heart failure.
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性别影响非缺血性心力衰竭的人类的心肌流动和脂肪酸底物代谢。
DOI：
10.1007/s12350-016-0467-6
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Peterson LR
中科院分区：
文献类型：
--
作者：
Kadkhodayan A;Lin CH;Coggan AR;Kisrieva-Ware Z;Schechtman KB;Novak E;Joseph SM;Dávila-Román VG;Gropler RJ;Dence C;Peterson LR
在心力衰竭(HF)的动物模型中，心肌代谢从正常的偏爱高能量脂肪酸(FA)代谢转向更有效的燃料--葡萄糖。然而，FA(相对于葡萄糖)代谢产生更多的ATP/摩尔；因此FA代谢在HF中可能特别有利。性别对正常人心肌血流量(MBF)和基质代谢有调节作用。性别是否影响心力衰竭患者的MBF和代谢尚不清楚。我们研究了19名配对的非缺血性心力衰竭患者，他们的射血分数相似(≤均为35%)。正电子发射断层扫描定量测定MBF和心肌底物代谢。女性的MBF(毫升/克/分)、FA摄取(毫升/克/分)、利用率(nmoL/g/分)均高于男性(P<；0.005、0.005、0.05)，且倾向于更高的FA氧化程度(P=0.09)。这些发现与年龄、肥胖和胰岛素抵抗无关。在空腹心肌葡萄糖摄取或代谢方面没有性别差异。在对这些受试者的纵向随访(平均7岁)的探索性分析中，我们发现4名男性有重大心血管事件，而1名女性死于非心脏原因。MBF越高，无事件生存率越高(HR=0.31，P=0.02)。总之，在非缺血性心力衰竭中，女性的MBF和FA摄取和代谢高于男性，这些变化并不是由于影响心肌代谢的其他变量的差异(例如，年龄、肥胖或胰岛素抵抗)。此外，MBF越高，预后越好。在开发和靶向调节MBF和HF代谢的新型药物时，应考虑到这些性别相关的差异。
In animal models of heart failure (HF), myocardial metabolism shifts from the normal preference for high-energy fatty acid (FA) metabolism towards the more efficient fuel, glucose. However, FA (vs. glucose) metabolism generates more ATP/mole; thus FA metabolism may be especially advantageous in HF. Sex modulates myocardial blood flow (MBF) and substrate metabolism in normal humans. Whether sex affects MBF and metabolism in patients with HF is unknown. We studied 19 well-matched men and women with nonischemic HF with similar ejection fractions (all ≤ 35%). MBF and myocardial substrate metabolism were quantified using positron emission tomography. Women had higher MBF (mL/g/min), FA uptake (mL/g/min), utilization (nmol/g/min) (P<0.005, <0.005, <0.05, respectively) and trended towards higher FA oxidation than men (P=0.09). These findings were independent of age, obesity, and insulin resistance. There were no sex-related differences in fasting myocardial glucose uptake or metabolism. In an exploratory analysis of the longitudinal follow-up of these subjects (mean 7 y), we found that 4 men had a major cardiovascular event, while one woman died of non-cardiac causes. Higher MBF related to improved event-free survival (HR=0.31, P=0.02). In sum, in nonischemic HF, women have higher MBF and FA uptake and metabolism than men, and these changes are not due to differences in other variables that can affect myocardial metabolism (e.g., age, obesity, or insulin resistance). Moreover, higher MBF portends a better prognosis. These sex-related differences should be taken into account in the development and targeting of novel agents aimed at modulating in MBF and metabolism in HF.
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DOI：
10.1097/00075197-200111000-00006
发表时间：
2001-11-01
影响因子：
3.1
作者：
Blaak, E
通讯作者：
Blaak, E
影响因子：
20.1
作者：
Kolwicz SC Jr;Olson DP;Marney LC;Garcia-Menendez L;Synovec RE;Tian R
通讯作者：
Tian R
DOI：
10.1152/ajpheart.00887.2007
发表时间：
2007-12-01
影响因子：
4.8
作者：
Neglia, Danilo;De Caterina, Alberto;Recchia, Fabio A.
通讯作者：
Recchia, Fabio A.
影响因子：
9.3
作者：
Herrero, Pilar;Kisrieva-Ware, Zulfia;Gropler, Robert J.
通讯作者：
Gropler, Robert J.
影响因子：
37.8
作者：
Kaufmann, PA;Rimoldi, O;Camici, PG
通讯作者：
Camici, PG