Abstract
Our aim is to propose an inovative non-invasive analysis of heart contraction energetics, to be used for diagnosis and therapeutics follow-up in human heart pathologies. The analysis is based on the combination of non-invasive 31P-NMR and IRM techniques and the analytical background of metabolic modular control analysis (MoCA). Metabolic control analysis’ based approaches have been used by us and others to overcome the complexity of intra-cellular regulations and to describe and quantify controls and regulations in complex systems. We previously demonstrated that MoCA does bring new informations on the interplay between ATP demand and supply in heart contraction energetics. In the present study, MoCA was applied to beating Langendorff perfused guinea pig heart to describe qualitatively and quantitatively the global action of various inotropic effectors effector modifying (Adrenaline) or not (Levosimendan, a calcium-sensitizer; Frank-Starling effect) cytosolic calcium transients. MoCA allows to describe the relative importance of the different routes within the heart by which the inotropic effects are transmitted. The results show that in the absence of calcium transient changes, an energetic feed-back control occurs at the expense of total energy, like in skeletal muscle, while parallel activation of both supply and demand occurs after adrenaline addition, maintaining energy homeostasis (heart energetic paradigm). In conclusion, clinical application of System’s biology to the study of contraction energetics in patients may help to the understanding of the links between molecular events in pathologies and whole organ function / dysfunction.
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