Impaired myocardial oxygen metabolism and energy efficiency in patients with dilated cardiomyopathy.

IF 5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2026-09-25 DOI:10.1016/j.jocmr.2026.102800

Liya Dai, Jinhan Qiao, Keyan Wang, Ran Li, Yang Yang, Caleb Berberet, Qi Huang, Chenying Lu, Jiansong Ji, Scott M Bugenhagen, Thomas H Schindler, Linda R Peterson, Pamela K Woodard, Yong Zhang, Jie Zheng

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引用次数: 0

Abstract

Background: Myocardial oxygen metabolism and mechano-energetic efficiency are key determinants of cardiac function and clinical outcomes, but their status in dilated cardiomyopathy (DCM) remains incompletely understood. This study applied a non-contrast cardiovascular magnetic resonance (CMR) technique to assess myocardial oxygenation, cardiac work, and energy efficiency in DCM.

Methods: We enrolled 49 DCM patients and 23 age- and sex- matched controls. All subjects underwent cine CMR imaging for left ventricular ejection fraction (LVEF) and global longitudinal strain (LVGLS), pre- and post-contrast T1 mapping for extracellular volume (ECV), and first-pass perfusion imaging for semi-quantification of myocardial blood flow (MBF). A non-contrast CMR technique was applied to quantify myocardial oxygen extraction fraction (mOEF). Semi-quantitative myocardial oxygen consumption (MVO₂), external work (EW), and myocardial external efficiency (MEE) were derived for analysis.

Results: Compared with controls, DCM patients exhibited significantly lower mOEF (50.3 [47.9, 53.9] % vs. 57.6 [56.2, 60.4] %, p < 0.001), MVO₂ per gram tissue (0.07 ± 0.01 vs. 0.08 ± 0.01, p = 0.027), EW (248.38 ± 97.87 vs. 341.88 ± 86.98mmHg×mL/min×10³, p < 0.001), and MEE (22.88 ± 10.62% vs. 45.95 ± 10.53%, p < 0.001), but higher total MVO₂ (7.99 ± 2.58 vs. 5.30 ± 1.48, p < 0.001). Resting mOEF showed no significant association with LVEF and LVGLS, whereas total MVO₂ and MEE correlated significantly with both LVEF and LVGLS. Female DCM patients exhibited higher LVEF (31.30 ± 10.18% vs. 22.47 ± 9.74%, p = 0.006), absolute LVGLS (9.81 ± 3.55% vs. 7.24 ± 2.86%, p = 0.011) and MEE (27.29 ± 11.87% vs. 20.74 ± 9.43%, p = 0.049) compared with males.

Conclusion: This feasibility study demonstrates the potential of this non-contrast CMR technique for noninvasive assessment of myocardial oxygen metabolism and mechano-energetic coupling in DCM. Patients with DCM showed impaired resting myocardial oxygen metabolism and reduced energy efficiency.

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.