Trening og energistoffskifte

-- END REPORT -- BACKGROUND: Heart failure is associated with reduced exercise capacity and impaired myocardial and skeletal muscle metabolism. Other factors, such as inborn genetic difference, ageing, and exercise training, can also lead to different exercise capacity. The purpose of this PhD project was to use magnetic resonance spectroscopy (MRS) to determine metabolic profiles in myocardial and skeletal muscle, associated with heart failure and exercise capacity, and thus identify targets for clinical MRS in vivo. METHODS: Two experimental models in rats were used. Coronary artery ligation was applied to induce heart failure, and low versus high capacity runners (LCR/HCR) were used to mimic individuals with different intrinsic exercise capacity. LCR/HCR rats were divided into 9 and 18 months groups to investigate the effect of ageing. In heart failure, exercise training was performed at moderate and high intensity. In LCR/HCR training intensity was high, whereas frequency was reduced. Magnetic resonance spectra were acquired from myocardial or skeletal muscle extracts. A combination of univariate (t-test and analysis of variance) and multivariate methods (principal component analysis or partial least square discriminative analysis) were used to determine the differences in metabolic profile. RESULTS: Heart failure affected multiple metabolic pathways, including creatine metabolism, glucose metabolism, glutamine metabolism, and aspartate metabolism, whereas it had a limited effect on skeletal muscle metabolism. Exercise training increased adenosine triphosphate and decreased glucose in the myocardium. In addition, it altered the skeletal muscle metabolism by regulating the metabolism of taurine, hypotaurine, and carnitine. In the LCR/HCR model, high intrinsic fitness was associated with higher glutamine and glutamate, as well as lower lactate levels in skeletal muscle. Ageing was associated with increased glycerophosphocholine and glucose levels. Exercise training did not cause any detectable changes on metabolic profile in LCR/HCR. CONCLUSION: MRS spectroscopy identified several myocardial and skeletal muscle metabolic profiles associated with the characteristic changes in cardiac function and aerobic fitness in heart failure, exercise training, ageing and intrinsic running capacity. Although some of them pointed to pathways of putative mechanistic importance, further research is necessary to determine their potential as diagnostic and prognostic biomarkers. BACKGROUND The present PhD project was the first step in an attempt to develop new MR-based medical technology to evaluate the functional state of the heart muscle in patients with heart disease. It applied MR spectroscopy (MRS) analysis of tissue samples from experimental models to investigate whether this approach has the potential to identify changes in relevant metabolic pathways. RESULTS MRS spectroscopy identified several myocardial and skeletal muscle metabolic profiles associated with the characteristic changes in cardiac function and aerobic fitness in heart failure, exercise training, ageing and intrinsic running capacity. • Heart failure affected the myocardial metabolism of creatine, glucose, glutamine and aspartate metabolism, whereas it had a limited effect on skeletal muscle metabolism. • Exercise training increased adenosine triphosphate and decreased glucose in the myocardium. In skeletal muscle, it regulated the metabolism of taurine, hypotaurine, and carnitine. • Ageing was associated with increased glycerophosphocholine and glucose levels. • High intrinsic running capacity was associated with higher glutamine and glutamate, as well as lower lactate levels in skeletal muscle. In general, the metabolic changes in heart failure and ageing pointed towards negative effects on cardiac function, whereas the profiles in exercise training and high intrinsic running capacity were associated with favourable effects. CONCLUSION Although some of the metabolic profiles pointed to pathways of putative mechanistic importance, further research is necessary to determine their potential as diagnostic biomarkers.