Sections of a normal heart and a heart in which energy production deficiency caused dilation of the chambers , which is a sign of heart failure. Credit: Paul Delgado-Olguin/The Hospital for Sick Children
Researchers at The Hospital for Sick Children have discovered that one of the earliest signs of heart failure is a change in how the heart produces energy, with findings offering a potential way to pre-empt heart failure before the heart begins to deteriorate. “We were surprised to find that dysregulation of energy production was the earliest sign of heart failure,” says Delgado-Olguín. “People associate deficiency in energy production with later stage heart failure, but our findings show this could actually be the cause of heart failure, not a result.”In a healthy heart a protein called lysine demethylase 8 helps to maintain a balanced energy use, also known as metabolism, by repressing TBX15, another protein that decreases energy production.
After identifying change in energy production as an early sign of heart failure, the research team drilled down further to explore how metabolic pathways could be modified to prevent the failure. In doing so they found that the nicotinamide adenine dinucleotide pathway, which regulates energy metabolism, was less active.