Serum Peroxisome Proliferator-activated Receptor Gamma Coactivator-1α Related to Myocardial Energy Expenditure in Patients With Chronic Heart Failure

Background: Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1 alpha) plays key roles in controlling cardiac metabolism and function. Myocardial energy expenditure (MEE) can reflect myocardial energy metabolism and cardiac function. Whether the variation of PGC-1 alpha can influence MEE levels in chronic heart failure (CHF) is unclear. Therefore, we investigated the relationship between PGC-1 alpha and MEE. Material and Methods: We studied 219 patients with CHF and 66 healthy controls. MEE was measured according to echocardiographic parameters. Serum PGC-1 alpha, N-terminal pro-B-type natriuretic peptide and other parameters were detected. Patients with CHF were divided into different groups according to the left ventricular ejection fraction (LVEF) and the tertile range of MEE. Results: Serum PGC-1 alpha was lower in the MEE 2 and 3 groups compared with controls (both P < 0.05). Patients in the MEE 2 (1.73 +/- 0.83 versus 2.16 +/- 0.82 ng/mL, P = 0.001) and 3 groups (1.65 +/- 0.73 versus 2.16 +/- 0.82 ng/mL, P < 0.001) possessed lower levels of PGC-1 alpha than those in the MEE 1 group. Compared with high LVEF, patients with low LVEF had higher MEE (median, 167 versus 73 cal/minute, P < 0.05) and lower PGC-1 alpha (1.71 +/- 0.65 versus 1.95 +/- 0.91 ng/mL, P = 0.032). Multivariate logistic regression analysis showed that MEE (OR = 0.517, 95% CI = 0.267-0.998, P = 0.049) and creatinine (OR = 2.704, 95% CI = 1.144-6.391, P = 0.023) were independently associated with increased PGC-1 alpha. Conclusions: Serum PGC-1 alpha was related to MEE and LVEF in patients with CHF and can reflect the degree of MEE and the systolic function of the left ventricle.