{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:33:40Z","timestamp":1786980820019,"version":"build-2736575974"},"reference-count":118,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["04510012010041"],"award-info":[{"award-number":["04510012010041"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Cardiovasc Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Genetic cardiomyopathies (CMPs) are a known cause of morbidity and mortality, with up to 50% of patients diagnosed below the age of 40 years for certain CMPs. With the improved availability of advanced imaging tools, significant progress has been made in early diagnosis and subsequent management. Due to the growing scientific interest in the genetic variants underlying these CMPs, data supporting a possible direct effect of the disease-defining genetic variant on cardiac metabolism have accumulated. Moreover, metabolic impairment seems to be correlated with phenotype, performance status and eventually prognosis at any stage of the disease. In this review we aim to outline the existing evidence supporting the use of imaging techniques to visualize and quantify myocardial metabolism in different CMPs. The review focuses on positron emission tomography (PET), single photon emission computed tomography (SPECT) and magnetic resonance spectroscopy (MRS), describing the basics of their functioning, strengths and weaknesses, and their use in the context of different CMPs. Finally, the latest technologies in this field and potential future directions in disease diagnosis and management are described.<\/jats:p>","DOI":"10.1007\/s10554-025-03470-2","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T07:42:31Z","timestamp":1754638951000},"page":"1881-1894","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Imaging of metabolic dysfunction in genetic cardiomyopathies"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9486-9618","authenticated-orcid":false,"given":"Giulia","family":"De Zan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Guglielmo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J.","family":"Cramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein","family":"Hol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"van der Harst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Velthuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine J.","family":"Prompers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneline S.J.M.","family":"te Riele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"3470_CR1","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1161\/res.0000000000000097","volume":"118","author":"H Taegtmeyer","year":"2016","unstructured":"Taegtmeyer H, Young ME, Lopaschuk GD, Abel ED, Brunengraber H, Darley-Usmar V, Des Rosiers C, Gerszten R, Glatz JF, Griffin JL et al (2016) Assessing cardiac metabolism: A scientific statement from the American heart association. Circ Res 118:1659\u20131701. https:\/\/doi.org\/10.1161\/res.0000000000000097","journal-title":"Circ Res"},{"key":"3470_CR2","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1146\/annurev.ph.36.030174.002213","volume":"36","author":"JR Neely","year":"1974","unstructured":"Neely JR, Morgan HE (1974) Relationship between carbohydrate and lipid metabolism and the energy balance of heart muscle. Annu Rev Physiol 36:413\u2013459. https:\/\/doi.org\/10.1146\/annurev.ph.36.030174.002213","journal-title":"Annu Rev Physiol"},{"key":"3470_CR3","first-page":"27","volume":"50","author":"RJ Bing","year":"1954","unstructured":"Bing RJ (1954) The metabolism of the heart. Harvey Lect 50:27\u201370","journal-title":"Harvey Lect"},{"key":"3470_CR4","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1152\/physrev.00015.2009","volume":"90","author":"GD Lopaschuk","year":"2010","unstructured":"Lopaschuk GD, Ussher JR, Folmes CD, Jaswal JS, Stanley WC (2010) Myocardial fatty acid metabolism in health and disease. Physiol Rev 90:207\u2013258. https:\/\/doi.org\/10.1152\/physrev.00015.2009","journal-title":"Physiol Rev"},{"key":"3470_CR5","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/s0140-6736(63)91500-9","volume":"1","author":"PJ Randle","year":"1963","unstructured":"Randle PJ, Garland PB, Hales CN, Newsholme EA (1963) The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet 1:785\u2013789. https:\/\/doi.org\/10.1016\/s0140-6736(63)91500-9","journal-title":"Lancet"},{"issue":"Suppl 1","key":"3470_CR6","doi-asserted-by":"publisher","first-page":"88s","DOI":"10.2967\/jnumed.109.068197","volume":"51","author":"RJ Gropler","year":"2010","unstructured":"Gropler RJ, Beanlands RS, Dilsizian V, Lewandowski ED, Villanueva FS, Ziadi MC (2010) Imaging myocardial metabolic remodeling. J Nucl Med 51(Suppl 1):88s\u2013101s. https:\/\/doi.org\/10.2967\/jnumed.109.068197","journal-title":"J Nucl Med"},{"key":"3470_CR7","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1161\/CIRCRESAHA.121.318241","volume":"128","author":"GD Lopaschuk","year":"2021","unstructured":"Lopaschuk GD, Karwi QG, Tian R, Wende AR, Abel ED (2021) Cardiac energy metabolism in heart failure. Circ Res 128:1487\u20131513. https:\/\/doi.org\/10.1161\/CIRCRESAHA.121.318241","journal-title":"Circ Res"},{"key":"3470_CR8","doi-asserted-by":"publisher","unstructured":"Witjas-Paalberends ER, G\u00fc\u00e7l\u00fc A, Germans T, Knaapen P, Harms HJ, Vermeer AMC, Christiaans I, Wilde AAM, Dos Remedios C, Lammertsma AA et al (2014) Gene-specific increase in the energetic cost of contraction in hypertrophic cardiomyopathy caused by Thick filament mutations. Cardiovascular Res 103:248\u2013257. https:\/\/doi.org\/10.1093\/cvr\/cvu127","DOI":"10.1093\/cvr\/cvu127"},{"key":"3470_CR9","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1038\/s41569-018-0044-6","volume":"15","author":"E Bertero","year":"2018","unstructured":"Bertero E, Maack C (2018) Metabolic remodelling in heart failure. Nat Rev Cardiol 15:457\u2013470. https:\/\/doi.org\/10.1038\/s41569-018-0044-6","journal-title":"Nat Rev Cardiol"},{"key":"3470_CR10","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/j.jchf.2023.02.007","volume":"11","author":"D Rodolico","year":"2023","unstructured":"Rodolico D, Schiattarella GG, Taegtmeyer H (2023) The lure of cardiac metabolism in the diagnosis, prevention, and treatment of heart failure. JACC Heart Fail 11:637\u2013645. https:\/\/doi.org\/10.1016\/j.jchf.2023.02.007","journal-title":"JACC Heart Fail"},{"key":"3470_CR11","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1016\/s0735-1097(00)00870-6","volume":"36","author":"H Taegtmeyer","year":"2000","unstructured":"Taegtmeyer H (2000) Metabolism\u2013the lost child of cardiology. J Am Coll Cardiol 36:1386\u20131388. https:\/\/doi.org\/10.1016\/s0735-1097(00)00870-6","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR12","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1161\/circresaha.120.315899","volume":"126","author":"LR Peterson","year":"2020","unstructured":"Peterson LR, Gropler RJ (2020) Metabolic and molecular imaging of the diabetic cardiomyopathy. Circ Res 126:1628\u20131645. https:\/\/doi.org\/10.1161\/circresaha.120.315899","journal-title":"Circ Res"},{"key":"3470_CR13","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.zemedi.2022.08.004","volume":"33","author":"A Zatcepin","year":"2023","unstructured":"Zatcepin A, Ziegler SI (2023) Detectors in positron emission tomography. Z Med Phys 33:4\u201312. https:\/\/doi.org\/10.1016\/j.zemedi.2022.08.004","journal-title":"Z Med Phys"},{"key":"3470_CR14","doi-asserted-by":"publisher","first-page":"3152","DOI":"10.1007\/s12350-021-02697-5","volume":"29","author":"W Fang","year":"2022","unstructured":"Fang W, Hsu B (2022) Myocardial blood flow quantitation with the SPECT technique: is it ready to be a substitute for PET myocardial blood flow quantitation? J Nucl Cardiol 29:3152\u20133154. https:\/\/doi.org\/10.1007\/s12350-021-02697-5","journal-title":"J Nucl Cardiol"},{"key":"3470_CR15","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/jmri.27531","volume":"54","author":"AJ Bakermans","year":"2021","unstructured":"Bakermans AJ, Boekholdt SM, de Vries DK, Reckman YJ, Farag ES, de Heer P, Uthman L, Denis SW, Zuurbier CJ, Houtkooper RH et al (2021) Quantification of myocardial creatine and triglyceride content in the human heart: precision and accuracy of in vivo proton magnetic resonance spectroscopy. J Magn Reson Imaging 54:411\u2013420. https:\/\/doi.org\/10.1002\/jmri.27531","journal-title":"J Magn Reson Imaging"},{"key":"3470_CR16","doi-asserted-by":"publisher","first-page":"1939","DOI":"10.1016\/j.bbadis.2017.11.013","volume":"1864","author":"D Abdurrachim","year":"2018","unstructured":"Abdurrachim D, Prompers JJ (2018) Evaluation of cardiac energetics by non-invasive (31)P magnetic resonance spectroscopy. Biochim Biophys Acta Mol Basis Dis 1864:1939\u20131948. https:\/\/doi.org\/10.1016\/j.bbadis.2017.11.013","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"3470_CR17","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1148\/radiology.191.3.8184033","volume":"191","author":"PA Bottomley","year":"1994","unstructured":"Bottomley PA (1994) MR spectroscopy of the human heart: the status and the challenges. Radiology 191:593\u2013612. https:\/\/doi.org\/10.1148\/radiology.191.3.8184033","journal-title":"Radiology"},{"key":"3470_CR18","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1002\/mrm.21027","volume":"56","author":"H K\u00f6stler","year":"2006","unstructured":"K\u00f6stler H, Landsch\u00fctz W, Koeppe S, Seyfarth T, Lipke C, Sandstede J, Spindler M, von Kienlin M, Hahn D, Beer M (2006) Age and gender dependence of human cardiac phosphorus metabolites determined by SLOOP 31P MR spectroscopy. Magn Reson Med 56:907\u2013911. https:\/\/doi.org\/10.1002\/mrm.21027","journal-title":"Magn Reson Med"},{"key":"3470_CR19","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1161\/01.CIR.97.7.666","volume":"97","author":"BM Pluim","year":"1998","unstructured":"Pluim BM, Lamb HJ, Kayser HWM, Leujes F, Beyerbacht HP, Zwinderman AH, van der Laarse A, Vliegen HW, de Roos A, van der Wall EE (1998) Functional and metabolic evaluation of the athlete\u2019s heart by magnetic resonance imaging and dobutamine stress magnetic resonance spectroscopy. Circulation 97:666\u2013672. https:\/\/doi.org\/10.1161\/01.CIR.97.7.666","journal-title":"Circulation"},{"key":"3470_CR20","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1126\/science.6450446","volume":"211","author":"SP Bessman","year":"1981","unstructured":"Bessman SP, Geiger PJ (1981) Transport of energy in muscle: the phosphorylcreatine shuttle. Science 211:448\u2013452. https:\/\/doi.org\/10.1126\/science.6450446","journal-title":"Science"},{"key":"3470_CR21","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s00424-019-02259-2","volume":"471","author":"JA Spudich","year":"2019","unstructured":"Spudich JA (2019) Three perspectives on the molecular basis of hypercontractility caused by hypertrophic cardiomyopathy mutations. Pflugers Arch 471:701\u2013717. https:\/\/doi.org\/10.1007\/s00424-019-02259-2","journal-title":"Pflugers Arch"},{"key":"3470_CR22","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.1038\/s41467-019-10555-9","volume":"10","author":"AS Adhikari","year":"2019","unstructured":"Adhikari AS, Trivedi DV, Sarkar SS, Song D, Kooiker KB, Bernstein D, Spudich JA, Ruppel KM (2019) \u03b2-cardiac myosin hypertrophic cardiomyopathy mutations release sequestered heads and increase enzymatic activity. Nat Commun 10:2685. https:\/\/doi.org\/10.1038\/s41467-019-10555-9","journal-title":"Nat Commun"},{"key":"3470_CR23","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/s0168-9525(03)00081-7","volume":"19","author":"H Ashrafian","year":"2003","unstructured":"Ashrafian H, Redwood C, Blair E, Watkins H (2003) Hypertrophic cardiomyopathy: a paradigm for myocardial energy depletion. Trends Genet 19:263\u2013268. https:\/\/doi.org\/10.1016\/s0168-9525(03)00081-7","journal-title":"Trends Genet"},{"key":"3470_CR24","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s12265-009-9131-8","volume":"2","author":"C Ferrantini","year":"2009","unstructured":"Ferrantini C, Belus A, Piroddi N, Scellini B, Tesi C, Poggesi C (2009) Mechanical and energetic consequences of HCM-causing mutations. J Cardiovasc Transl Res 2:441\u2013451. https:\/\/doi.org\/10.1007\/s12265-009-9131-8","journal-title":"J Cardiovasc Transl Res"},{"key":"3470_CR25","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1093\/cvr\/cvu127","volume":"103","author":"ER Witjas-Paalberends","year":"2014","unstructured":"Witjas-Paalberends ER, G\u00fc\u00e7l\u00fc A, Germans T, Knaapen P, Harms HJ, Vermeer AM, Christiaans I, Wilde AA, Dos Remedios C, Lammertsma AA et al (2014) Gene-specific increase in the energetic cost of contraction in hypertrophic cardiomyopathy caused by Thick filament mutations. Cardiovasc Res 103:248\u2013257. https:\/\/doi.org\/10.1093\/cvr\/cvu127","journal-title":"Cardiovasc Res"},{"key":"3470_CR26","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s12471-019-1239-0","volume":"27","author":"BO van Driel","year":"2019","unstructured":"van Driel BO, van Rossum AC, Michels M, Huurman R, van der Velden J (2019) Extra energy for hearts with a genetic defect: ENERGY trial. Neth Heart J 27:200\u2013205. https:\/\/doi.org\/10.1007\/s12471-019-1239-0","journal-title":"Neth Heart J"},{"key":"3470_CR27","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1093\/ehjci\/jes242","volume":"14","author":"SAJ Timmer","year":"2012","unstructured":"Timmer SAJ, Knaapen P (2012) Coronary microvascular function, myocardial metabolism, and energetics in hypertrophic cardiomyopathy: insights from positron emission tomography. Eur Heart J-Cardiovasc Imaging 14:95\u2013101. https:\/\/doi.org\/10.1093\/ehjci\/jes242","journal-title":"Eur Heart J-Cardiovasc Imaging"},{"key":"3470_CR28","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1161\/01.cir.80.4.863","volume":"80","author":"JJ Armbrecht","year":"1989","unstructured":"Armbrecht JJ, Buxton DB, Brunken RC, Phelps ME, Schelbert HR (1989) Regional myocardial oxygen consumption determined noninvasively in humans with [1-11 C]acetate and dynamic positron tomography. Circulation 80:863\u2013872. https:\/\/doi.org\/10.1161\/01.cir.80.4.863","journal-title":"Circulation"},{"key":"3470_CR29","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1093\/ehjci\/jes242","volume":"14","author":"SA Timmer","year":"2013","unstructured":"Timmer SA, Knaapen P (2013) Coronary microvascular function, myocardial metabolism, and energetics in hypertrophic cardiomyopathy: insights from positron emission tomography. Eur Heart J Cardiovasc Imaging 14:95\u2013101. https:\/\/doi.org\/10.1093\/ehjci\/jes242","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"3470_CR30","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0002-8703(97)70143-1","volume":"133","author":"S Ishiwata","year":"1997","unstructured":"Ishiwata S, Maruno H, Senda M, Toyama H, Nishiyama S, Seki A (1997) Mechanical efficiency in hypertrophic cardiomyopathy assessed by positron emission tomography with carbon 11 acetate. Am Heart J 133:497\u2013503. https:\/\/doi.org\/10.1016\/S0002-8703(97)70143-1","journal-title":"Am Heart J"},{"key":"3470_CR31","first-page":"390","volume":"39","author":"E Tadamura","year":"1998","unstructured":"Tadamura E, Kudoh T, Hattori N, Inubushi M, Magata Y, Konishi J, Matsumori A, Nohara R, Sasayama S, Yoshibayashi M et al (1998) Impairment of BMIPP uptake precedes abnormalities in oxygen and glucose metabolism in hypertrophic cardiomyopathy. J Nucl Med 39:390\u2013396","journal-title":"J Nucl Med"},{"key":"3470_CR32","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.nuclcard.2006.12.329","volume":"14","author":"H Tuunanen","year":"2007","unstructured":"Tuunanen H, Kuusisto J, Toikka J, J\u00e4\u00e4skel\u00e4inen P, Marjam\u00e4ki P, Peuhkurinen K, Viljanen T, Sipola P, Stolen KQ, Hannukainen J et al (2007) Myocardial perfusion, oxidative metabolism, and free fatty acid uptake in patients with hypertrophic cardiomyopathy attributable to the Asp175Asn mutation in the \u03b1-tropomyosin gene: A positron emission tomography study. J Nuclear Cardiol 14:354\u2013365. https:\/\/doi.org\/10.1016\/j.nuclcard.2006.12.329","journal-title":"J Nuclear Cardiol"},{"key":"3470_CR33","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00259-009-1350-3","volume":"37","author":"SAJ Timmer","year":"2010","unstructured":"Timmer SAJ, Germans T, G\u00f6tte MJW, R\u00fcssel IK, Dijkmans PA, Lubberink M, ten Berg JM, ten Cate FJ, Lammertsma AA, Knaapen P et al (2010) Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy. Eur J Nucl Med Mol Imaging 37:779\u2013788. https:\/\/doi.org\/10.1007\/s00259-009-1350-3","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"3470_CR34","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.005604","volume":"10","author":"A G\u00fc\u00e7l\u00fc","year":"2017","unstructured":"G\u00fc\u00e7l\u00fc A, Knaapen P, Harms HJ, Parbhudayal RY, Michels M, Lammertsma AA, van Rossum AC, Germans T, van der Velden J (2017) Disease stage\u2013dependent changes in cardiac contractile performance and oxygen utilization underlie reduced myocardial efficiency in human inherited hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 10:e005604. https:\/\/doi.org\/10.1161\/CIRCIMAGING.116.005604","journal-title":"Circ Cardiovasc Imaging"},{"key":"3470_CR35","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/s0735-1097(86)80181-4","volume":"8","author":"BJ Maron","year":"1986","unstructured":"Maron BJ, Wolfson JK, Epstein SE, Roberts WC (1986) Intramural (small vessel) coronary artery disease in hypertrophic cardiomyopathy. J Am Coll Cardiol 8:545\u2013557. https:\/\/doi.org\/10.1016\/s0735-1097(86)80181-4","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR36","doi-asserted-by":"publisher","unstructured":"The metabolic basis of inherited disease. 6th Edition. Japanese journal of human genetics (1989) 34, 253\u2013253. https:\/\/doi.org\/10.1007\/BF01900731","DOI":"10.1007\/BF01900731"},{"key":"3470_CR37","doi-asserted-by":"publisher","first-page":"H1756","DOI":"10.1152\/ajpheart.1991.261.6.H1756","volume":"261","author":"RR Russell III","year":"1991","unstructured":"Russell RR 3rd;, Taegtmeyer H (1991) Pyruvate carboxylation prevents the decline in contractile function of rat hearts oxidizing acetoacetate. Am J Physiol 261:H1756\u20131762. https:\/\/doi.org\/10.1152\/ajpheart.1991.261.6.H1756","journal-title":"Am J Physiol"},{"key":"3470_CR38","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s11897-013-0133-0","volume":"10","author":"K Drosatos","year":"2013","unstructured":"Drosatos K, Schulze PC (2013) Cardiac lipotoxicity: molecular pathways and therapeutic implications. Curr Heart Fail Rep 10:109\u2013121. https:\/\/doi.org\/10.1007\/s11897-013-0133-0","journal-title":"Curr Heart Fail Rep"},{"key":"3470_CR39","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1161\/hc0802.104535","volume":"105","author":"Y Jamshidi","year":"2002","unstructured":"Jamshidi Y, Montgomery HE, Hense HW, Myerson SG, Torra IP, Staels B, World MJ, Doering A, Erdmann J, Hengstenberg C et al (2002) Peroxisome proliferator\u2013activated receptor alpha gene regulates left ventricular growth in response to exercise and hypertension. Circulation 105:950\u2013955. https:\/\/doi.org\/10.1161\/hc0802.104535","journal-title":"Circulation"},{"key":"3470_CR40","doi-asserted-by":"publisher","unstructured":"Zhao C, Shuke N, Okizaki A, Yamamoto W, Sato J, Ishikawa Y, Ohta T, Hasebe N, Kikuchi K, Aburano T (2003) Comparison of myocardial fatty acid metabolism with left ventricular function and perfusion in cardiomyopathies: by 123I-BMIPP SPECT and 99mTc-tetrofosmin electrocardiographically gated SPECT. Ann Nucl Med 17:541\u2013548. https:\/\/doi.org\/10.1007\/bf03006666","DOI":"10.1007\/bf03006666"},{"key":"3470_CR41","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1097\/00006231-199311000-00012","volume":"14","author":"T Shimonagata","year":"1993","unstructured":"Shimonagata T, Nishimura T, Uehara T, Hayashida K, Kumita S, Ohno A, Nagata S, Miyatake K (1993) Discrepancies between myocardial perfusion and free fatty acid metabolism in patients with hypertrophic cardiomyopathy. Nucl Med Commun 14:1005\u20131013. https:\/\/doi.org\/10.1097\/00006231-199311000-00012","journal-title":"Nucl Med Commun"},{"key":"3470_CR42","first-page":"6","volume":"33","author":"C Kurata","year":"1992","unstructured":"Kurata C, Tawarahara K, Taguchi T, Aoshima S, Kobayashi A, Yamazaki N, Kawai H, Kaneko M (1992) Myocardial emission computed tomography with iodine-123-labeled beta-methyl-branched fatty acid in patients with hypertrophic cardiomyopathy. J Nucl Med 33:6\u201313","journal-title":"J Nucl Med"},{"key":"3470_CR43","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1023\/b:caim.0000004262.48898.5d","volume":"19","author":"M Narita","year":"2003","unstructured":"Narita M, Kurihara T, Is (2003) I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid imaging useful to evaluate asymptomatic patients with hypertrophic cardiomyopathy? I-123 BMIPP imaging to evaluate asymptomatic hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 19:499\u2013510. https:\/\/doi.org\/10.1023\/b:caim.0000004262.48898.5d","journal-title":"Int J Cardiovasc Imaging"},{"issue":"Suppl 1","key":"3470_CR44","first-page":"121","volume":"37","author":"Y Ishida","year":"2001","unstructured":"Ishida Y, Nagata S, Uehara T, Yasumura Y, Fukuchi K, Miyatake K (2001) Clinical analysis of myocardial perfusion and metabolism in patients with hypertrophic cardiomyopathy by single photon emission tomography and positron emission tomography. J Cardiol 37(Suppl 1):121\u2013128","journal-title":"J Cardiol"},{"key":"3470_CR45","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1253\/jcj.52.111","volume":"52","author":"T Mori","year":"1988","unstructured":"Mori T, Yamabe H, Yokota Y, Fukuzaki H, CLINICAL SIGNIFICANCE OF, DIPYRIDAMOLE Tl-201 EMISSION COMPUTED TOMOGRAPHY PERFUSION ABNORMALITY FOR EVALUATING PATHOPHYSIOLOGICAL AND PATHOLOGICAL ASPECTS IN HYPERTROPHIC CARDIOMYOPATHY (1988) Jpn Circ J 52:111\u2013118. https:\/\/doi.org\/10.1253\/jcj.52.111","journal-title":"Jpn Circ J"},{"key":"3470_CR46","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1097\/MNM.0b013e32828da1c7","volume":"28","author":"A Okizaki","year":"2007","unstructured":"Okizaki A, Shuke N, Sato J, Sasaki T, Hasebe N, Kikuchi K, Aburano T (2007) A compartment model analysis for investigation of myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy. Nucl Med Commun 28:726\u2013735. https:\/\/doi.org\/10.1097\/MNM.0b013e32828da1c7","journal-title":"Nucl Med Commun"},{"key":"3470_CR47","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1016\/S0735-1097(02)03009-7","volume":"41","author":"JG Crilley","year":"2003","unstructured":"Crilley JG, Boehm EA, Blair E, Rajagopalan B, Blamire AM, Styles P, McKenna WJ, \u00d6stman-Smith I, Clarke K, Watkins H (2003) Hypertrophic cardiomyopathy due to sarcomeric gene mutations is characterized by impaired energy metabolism irrespective of the degree of hypertrophy. J Am Coll Cardiol 41:1776\u20131782. https:\/\/doi.org\/10.1016\/S0735-1097(02)03009-7","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR48","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.ejrad.2008.10.018","volume":"73","author":"GN Shivu","year":"2010","unstructured":"Shivu GN, Abozguia K, Phan TT, Ahmed I, Henning A, Frenneaux M (2010) (31)P magnetic resonance spectroscopy to measure in vivo cardiac energetics in normal myocardium and hypertrophic cardiomyopathy: experiences at 3T. Eur J Radiol 73:255\u2013259. https:\/\/doi.org\/10.1016\/j.ejrad.2008.10.018","journal-title":"Eur J Radiol"},{"key":"3470_CR49","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1161\/01.CIR.101.12.e121","volume":"101","author":"W-I Jung","year":"2000","unstructured":"Jung W-I, Hoess T, Bunse M, Widmaier S, Sieverding L, Breuer J, Apitz J, Schmidt O, van Erckelens F, Dietze GJ et al (2000) Differences in cardiac energetics between patients with familial and nonfamilial hypertrophic cardiomyopathy. Circulation 101:e121\u2013e121. https:\/\/doi.org\/10.1161\/01.CIR.101.12.e121","journal-title":"Circulation"},{"key":"3470_CR50","doi-asserted-by":"publisher","first-page":"1775","DOI":"10.1172\/JCI1940","volume":"101","author":"M Spindler","year":"1998","unstructured":"Spindler M, Saupe KW, Christe ME, Sweeney HL, Seidman CE, Seidman JG, Ingwall JS (1998) Diastolic dysfunction and altered energetics in the alphaMHC403\/+ mouse model of familial hypertrophic cardiomyopathy. J Clin Invest 101:1775\u20131783. https:\/\/doi.org\/10.1172\/JCI1940","journal-title":"J Clin Invest"},{"key":"3470_CR51","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1093\/eurheartj\/ehv120","volume":"36","author":"S Dass","year":"2015","unstructured":"Dass S, Cochlin LE, Suttie JJ, Holloway CJ, Rider OJ, Carden L, Tyler DJ, Karamitsos TD, Clarke K, Neubauer S et al (2015) Exacerbation of cardiac energetic impairment during exercise in hypertrophic cardiomyopathy: a potential mechanism for diastolic dysfunction. Eur Heart J 36:1547\u20131554. https:\/\/doi.org\/10.1093\/eurheartj\/ehv120","journal-title":"Eur Heart J"},{"key":"3470_CR52","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3007328","volume":"5","author":"PA Bottomley","year":"2013","unstructured":"Bottomley PA, Panjrath GS, Lai S, Hirsch GA, Wu K, Najjar SS, Steinberg A, Gerstenblith G, Weiss RG (2013) Metabolic rates of ATP transfer through creatine kinase (CK flux) predict clinical heart failure events and death. Sci Transl Med 5:215re213. https:\/\/doi.org\/10.1126\/scitranslmed.3007328","journal-title":"Sci Transl Med"},{"key":"3470_CR53","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1161\/circulationaha.106.613646","volume":"114","author":"CS Smith","year":"2006","unstructured":"Smith CS, Bottomley PA, Schulman SP, Gerstenblith G, Weiss RG (2006) Altered creatine kinase adenosine triphosphate kinetics in failing hypertrophied human myocardium. Circulation 114:1151\u20131158. https:\/\/doi.org\/10.1161\/circulationaha.106.613646","journal-title":"Circulation"},{"key":"3470_CR54","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.cardfail.2010.05.006","volume":"16","author":"I Nakae","year":"2010","unstructured":"Nakae I, Mitsunami K, Yoshino T, Omura T, Tsutamoto T, Matsumoto T, Morikawa S, Inubushi T, Horie M (2010) Clinical features of myocardial triglyceride in different types of cardiomyopathy assessed by proton magnetic resonance spectroscopy: comparison with myocardial creatine. J Card Fail 16:812\u2013822. https:\/\/doi.org\/10.1016\/j.cardfail.2010.05.006","journal-title":"J Card Fail"},{"key":"3470_CR55","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1161\/01.res.78.5.893","volume":"78","author":"R Liao","year":"1996","unstructured":"Liao R, Nascimben L, Friedrich J, Gwathmey JK, Ingwall JS (1996) Decreased energy reserve in an animal model of dilated cardiomyopathy. Relationship to contractile performance. Circ Res 78:893\u2013902. https:\/\/doi.org\/10.1161\/01.res.78.5.893","journal-title":"Circ Res"},{"key":"3470_CR56","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.1161\/01.cir.91.6.1814","volume":"91","author":"BM Massie","year":"1995","unstructured":"Massie BM, Schaefer S, Garcia J, McKirnan MD, Schwartz GG, Wisneski JA, Weiner MW, White FC (1995) Myocardial high-energy phosphate and substrate metabolism in swine with moderate left ventricular hypertrophy. Circulation 91:1814\u20131823. https:\/\/doi.org\/10.1161\/01.cir.91.6.1814","journal-title":"Circulation"},{"key":"3470_CR57","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1097\/00000441-199907000-00006","volume":"318","author":"PM Barger","year":"1999","unstructured":"Barger PM, Kelly DP (1999) Fatty acid utilization in the hypertrophied and failing heart: molecular regulatory mechanisms. Am J Med Sci 318:36\u201342. https:\/\/doi.org\/10.1097\/00000441-199907000-00006","journal-title":"Am J Med Sci"},{"key":"3470_CR58","doi-asserted-by":"publisher","first-page":"H1068","DOI":"10.1152\/ajpheart.1992.262.4.H1068","volume":"262","author":"Z el Alaoui-Talibi","year":"1992","unstructured":"el Alaoui-Talibi Z, Landormy S, Loireau A, Moravec J (1992) Fatty acid oxidation and mechanical performance of volume-overloaded rat hearts. Am J Physiol 262:H1068\u20131074. https:\/\/doi.org\/10.1152\/ajpheart.1992.262.4.H1068","journal-title":"Am J Physiol"},{"key":"3470_CR59","doi-asserted-by":"publisher","first-page":"2837","DOI":"10.1161\/01.cir.94.11.2837","volume":"94","author":"MN Sack","year":"1996","unstructured":"Sack MN, Rader TA, Park S, Bastin J, McCune SA, Kelly DP (1996) Fatty acid oxidation enzyme gene expression is downregulated in the failing heart. Circulation 94:2837\u20132842. https:\/\/doi.org\/10.1161\/01.cir.94.11.2837","journal-title":"Circulation"},{"key":"3470_CR60","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1172\/jci10947","volume":"107","author":"HC Chiu","year":"2001","unstructured":"Chiu HC, Kovacs A, Ford DA, Hsu FF, Garcia R, Herrero P, Saffitz JE, Schaffer JE (2001) A novel mouse model of lipotoxic cardiomyopathy. J Clin Invest 107:813\u2013822. https:\/\/doi.org\/10.1172\/jci10947","journal-title":"J Clin Invest"},{"key":"3470_CR61","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/s0735-1097(02)01967-8","volume":"40","author":"VG D\u00e1vila-Rom\u00e1n","year":"2002","unstructured":"D\u00e1vila-Rom\u00e1n VG, Vedala G, Herrero P, de las Fuentes L, Rogers JG, Kelly DP, Gropler RJ (2002) Altered myocardial fatty acid and glucose metabolism in idiopathic dilated cardiomyopathy. J Am Coll Cardiol 40:271\u2013277. https:\/\/doi.org\/10.1016\/s0735-1097(02)01967-8","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR62","first-page":"55","volume":"42","author":"M Taylor","year":"2001","unstructured":"Taylor M, Wallhaus TR, Degrado TR, Russell DC, Stanko P, Nickles RJ, Stone CK (2001) An evaluation of myocardial fatty acid and glucose uptake using PET with [18F]fluoro-6-thia-heptadecanoic acid and [18F]FDG in patients with congestive heart failure. J Nucl Med 42:55\u201362","journal-title":"J Nucl Med"},{"key":"3470_CR63","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/0026-0495(94)90241-0","volume":"43","author":"G Paolisso","year":"1994","unstructured":"Paolisso G, Gambardella A, Galzerano D, D\u2019Amore A, Rubino P, Verza M, Teasuro P, Varricchio M, D\u2019Onofrio F (1994) Total-body and myocardial substrate oxidation in congestive heart failure. Metabolism 43:174\u2013179. https:\/\/doi.org\/10.1016\/0026-0495(94)90241-0","journal-title":"Metabolism"},{"key":"3470_CR64","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1161\/01.res.83.10.969","volume":"83","author":"FA Recchia","year":"1998","unstructured":"Recchia FA, McConnell PI, Bernstein RD, Vogel TR, Xu X, Hintze TH (1998) Reduced nitric oxide production and altered myocardial metabolism during the decompensation of pacing-induced heart failure in the conscious dog. Circ Res 83:969\u2013979. https:\/\/doi.org\/10.1161\/01.res.83.10.969","journal-title":"Circ Res"},{"key":"3470_CR65","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.cardfail.2006.06.005","volume":"12","author":"H Tuunanen","year":"2006","unstructured":"Tuunanen H, Engblom E, Naum A, Scheinin M, N\u00e5gren K, Airaksinen J, Nuutila P, Iozzo P, Ukkonen H, Knuuti J (2006) Decreased myocardial free fatty acid uptake in patients with idiopathic dilated cardiomyopathy: evidence of relationship with insulin resistance and left ventricular dysfunction. J Card Fail 12:644\u2013652. https:\/\/doi.org\/10.1016\/j.cardfail.2006.06.005","journal-title":"J Card Fail"},{"key":"3470_CR66","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/hrt.81.2.153","volume":"81","author":"Y Yazaki","year":"1999","unstructured":"Yazaki Y, Isobe M, Takahashi W, Kitabayashi H, Nishiyama O, Sekiguchi M, Takemura T (1999) Assessment of myocardial fatty acid metabolic abnormalities in patients with idiopathic dilated cardiomyopathy using 123I BMIPP SPECT: correlation with clinicopathological findings and clinical course. Heart 81:153\u2013159. https:\/\/doi.org\/10.1136\/hrt.81.2.153","journal-title":"Heart"},{"key":"3470_CR67","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1253\/circj.67.918","volume":"67","author":"R Sasaki","year":"2003","unstructured":"Sasaki R, Mitani I, Usui T, Kitamura Y, Yoshii Y, Ishikawa T, Uchino K, Takahashi N, Kimura K, Umemura S (2003) Clinical value of iodine-123 beta-methyliodophenyl pentadecanoic acid (BMIPP) myocardial single photon emission computed tomography for predicting cardiac death among patients with chronic heart failure. Circ J 67:918\u2013924. https:\/\/doi.org\/10.1253\/circj.67.918","journal-title":"Circ J"},{"key":"3470_CR68","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1161\/circimaging.109.934638","volume":"3","author":"PG Masci","year":"2010","unstructured":"Masci PG, Marinelli M, Piacenti M, Lorenzoni V, Positano V, Lombardi M, L\u2019Abbate A, Neglia D (2010) Myocardial structural, perfusion, and metabolic correlates of left bundle branch block mechanical derangement in patients with dilated cardiomyopathy: a tagged cardiac magnetic resonance and positron emission tomography study. Circ Cardiovasc Imaging 3:482\u2013490. https:\/\/doi.org\/10.1161\/circimaging.109.934638","journal-title":"Circ Cardiovasc Imaging"},{"key":"3470_CR69","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1007\/s12350-015-0165-9","volume":"23","author":"L Wang","year":"2016","unstructured":"Wang L, Ma X, Xiang L, Lu M, Yan C, Zhao S, Fang W (2016) The characterization and prognostic significance of right ventricular glucose metabolism in non-ischemic dilated cardiomyopathy. J Nucl Cardiol 23:758\u2013767. https:\/\/doi.org\/10.1007\/s12350-015-0165-9","journal-title":"J Nucl Cardiol"},{"key":"3470_CR70","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1093\/ehjci\/jeab227","volume":"23","author":"KB Hansen","year":"2022","unstructured":"Hansen KB, S\u00f6rensen J, Hansson NH, Nielsen R, Larsen AH, Fr\u00f8ki\u00e6r J, Tolbod LP, Gormsen LC, Harms HJ, Wiggers H (2022) Myocardial efficiency in patients with different aetiologies and stages of heart failure. Eur Heart J Cardiovasc Imaging 23:328\u2013337. https:\/\/doi.org\/10.1093\/ehjci\/jeab227","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"3470_CR71","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s002590050040","volume":"27","author":"FM Bengel","year":"2000","unstructured":"Bengel FM, Permanetter B, Ungerer M, Nekolla S, Schwaiger M (2000) Non-invasive estimation of myocardial efficiency using positron emission tomography and carbon-11 acetate\u2013comparison between the normal and failing human heart. Eur J Nucl Med 27:319\u2013326. https:\/\/doi.org\/10.1007\/s002590050040","journal-title":"Eur J Nucl Med"},{"key":"3470_CR72","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.cardfail.2003.08.009","volume":"10","author":"KQ Stolen","year":"2004","unstructured":"Stolen KQ, Kemppainen J, Kalliokoski KK, H\u00e4llsten K, Luotolahti M, Karanko H, Lehikoinen P, Viljanen T, Salo T, Airaksinen KE et al (2004) Myocardial perfusion reserve and oxidative metabolism contribute to exercise capacity in patients with dilated cardiomyopathy. J Card Fail 10:132\u2013140. https:\/\/doi.org\/10.1016\/j.cardfail.2003.08.009","journal-title":"J Card Fail"},{"key":"3470_CR73","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.1161\/01.CIR.94.8.1894","volume":"94","author":"L Nascimben","year":"1996","unstructured":"Nascimben L, Ingwall JS, Pauletto P, Friedrich J, Gwathmey JK, Saks V, Pessina AC (1996) Creatine kinase system in failing and nonfailing human myocardium. Circulation 94:1894\u20131901. https:\/\/doi.org\/10.1161\/01.CIR.94.8.1894","journal-title":"Circulation"},{"key":"3470_CR74","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1161\/01.cir.86.6.1810","volume":"86","author":"S Neubauer","year":"1992","unstructured":"Neubauer S, Krahe T, Schindler R, Horn M, Hillenbrand H, Entzeroth C, Mader H, Kromer EP, Riegger GAJ, Lackner K et al (1992) 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease: altered cardiac high-energy phosphate metabolism in heart failure. Circulation 86:1810\u20131818. https:\/\/doi.org\/10.1161\/01.cir.86.6.1810","journal-title":"Circulation"},{"key":"3470_CR75","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s00330-004-2504-0","volume":"15","author":"A Hansch","year":"2005","unstructured":"Hansch A, Rzanny R, Heyne JP, Leder U, Reichenbach JR, Kaiser WA (2005) Noninvasive measurements of cardiac high-energy phosphate metabolites in dilated cardiomyopathy by using 31P spectroscopic chemical shift imaging. Eur Radiol 15:319\u2013323. https:\/\/doi.org\/10.1007\/s00330-004-2504-0","journal-title":"Eur Radiol"},{"key":"3470_CR76","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1080\/02841850510021283","volume":"46","author":"K Chida","year":"2005","unstructured":"Chida K, Otani H, Saito H, Nagasaka T, Kagaya Y, Kohzuki M, Zuguchi M, Shirato K (2005) Feasibility of rapid-sequence 31P magnetic resonance spectroscopy in cardiac patients. Acta Radiol 46:386\u2013390. https:\/\/doi.org\/10.1080\/02841850510021283","journal-title":"Acta Radiol"},{"key":"3470_CR77","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1016\/j.jacc.2003.05.005","volume":"42","author":"I Nakae","year":"2003","unstructured":"Nakae I, Mitsunami K, Omura T, Yabe T, Tsutamoto T, Matsuo S, Takahashi M, Morikawa S, Inubushi T, Nakamura Y et al (2003) Proton magnetic resonance spectroscopy can detect creatine depletion associated with the progression of heart failure in cardiomyopathy. J Am Coll Cardiol 42:1587\u20131593. https:\/\/doi.org\/10.1016\/j.jacc.2003.05.005","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR78","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1016\/s0735-1097(02)02160-5","volume":"40","author":"M Beer","year":"2002","unstructured":"Beer M, Seyfarth T, Sandstede J, Landsch\u00fctz W, Lipke C, K\u00f6stler H, von Kienlin M, Harre K, Hahn D, Neubauer S (2002) Absolute concentrations of high-energy phosphate metabolites in normal, hypertrophied, and failing human myocardium measured noninvasively with (31)P-SLOOP magnetic resonance spectroscopy. J Am Coll Cardiol 40:1267\u20131274. https:\/\/doi.org\/10.1016\/s0735-1097(02)02160-5","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR79","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1073\/pnas.0408962102","volume":"102","author":"RG Weiss","year":"2005","unstructured":"Weiss RG, Gerstenblith G, Bottomley PA (2005) ATP flux through creatine kinase in the normal, stressed, and failing human heart. Proc Natl Acad Sci U S A 102:808\u2013813. https:\/\/doi.org\/10.1073\/pnas.0408962102","journal-title":"Proc Natl Acad Sci U S A"},{"key":"3470_CR80","doi-asserted-by":"publisher","unstructured":"Bottomley PA, Panjrath GS, Lai S, Hirsch GA, Wu K, Najjar SS, Steinberg A, Gerstenblith G, Weiss RG (2013) Metabolic rates of ATP transfer through creatine kinase (CK Flux) predict clinical heart failure events and death. Sci Transl Med 5(215re213\u2013215re213). https:\/\/doi.org\/10.1126\/scitranslmed.3007328","DOI":"10.1126\/scitranslmed.3007328"},{"key":"3470_CR81","first-page":"453","volume":"45","author":"S Neubauer","year":"1997","unstructured":"Neubauer S, Horn M, Pabst T, Harre K, Str\u00f6mer H, Bertsch G, Sandstede J, Ertl G, Hahn D, Kochsiek K (1997) Cardiac high-energy phosphate metabolism in patients with aortic valve disease assessed by 31P-magnetic resonance spectroscopy. J Investig Med 45:453\u2013462","journal-title":"J Investig Med"},{"key":"3470_CR82","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-018-0491-6","volume":"20","author":"RE Gabr","year":"2018","unstructured":"Gabr RE, El-Sharkawy A-MM, Sch\u00e4r M, Panjrath GS, Gerstenblith G, Weiss RG, Bottomley PA (2018) Cardiac work is related to creatine kinase energy supply in human heart failure: a cardiovascular magnetic resonance spectroscopy study. J Cardiovasc Magn Reson 20:81. https:\/\/doi.org\/10.1186\/s12968-018-0491-6","journal-title":"J Cardiovasc Magn Reson"},{"key":"3470_CR83","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1007\/s12350-018-01582-y","volume":"27","author":"SJ Kim","year":"2020","unstructured":"Kim SJ, Pak K, Kim K (2020) Diagnostic performance of F-18 FDG PET for detection of cardiac sarcoidosis; a systematic review and meta-analysis. J Nucl Cardiol 27:2103\u20132115. https:\/\/doi.org\/10.1007\/s12350-018-01582-y","journal-title":"J Nucl Cardiol"},{"key":"3470_CR84","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ijcard.2018.10.083","volume":"284","author":"A Protonotarios","year":"2019","unstructured":"Protonotarios A, Wicks E, Ashworth M, Stephenson E, Guttmann O, Savvatis K, Sekhri N, Mohiddin SA, Syrris P, Menezes L et al (2019) Prevalence of (18)F-fluorodeoxyglucose positron emission tomography abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy. Int J Cardiol 284:99\u2013104. https:\/\/doi.org\/10.1016\/j.ijcard.2018.10.083","journal-title":"Int J Cardiol"},{"key":"3470_CR85","doi-asserted-by":"publisher","first-page":"2851","DOI":"10.1016\/j.jacc.2020.04.022","volume":"75","author":"M Hanna","year":"2020","unstructured":"Hanna M, Ruberg FL, Maurer MS, Dispenzieri A, Dorbala S, Falk RH, Hoffman J, Jaber W, Soman P, Witteles RM et al (2020) Cardiac scintigraphy with Technetium-99m-Labeled Bone-Seeking tracers for suspected amyloidosis: JACC review topic of the week. J Am Coll Cardiol 75:2851\u20132862. https:\/\/doi.org\/10.1016\/j.jacc.2020.04.022","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR86","doi-asserted-by":"publisher","first-page":"2187","DOI":"10.1093\/eurheartj\/ehad139","volume":"44","author":"MU Rauf","year":"2023","unstructured":"Rauf MU, Hawkins PN, Cappelli F, Perfetto F, Zampieri M, Argiro A, Petrie A, Law S, Porcari A, Razvi Y et al (2023) Tc-99m labelled bone scintigraphy in suspected cardiac amyloidosis. Eur Heart J 44:2187\u20132198. https:\/\/doi.org\/10.1093\/eurheartj\/ehad139","journal-title":"Eur Heart J"},{"key":"3470_CR87","doi-asserted-by":"publisher","first-page":"e009974","DOI":"10.1161\/jaha.118.009974","volume":"7","author":"TS Clemmensen","year":"2018","unstructured":"Clemmensen TS, Soerensen J, Hansson NH, Tolbod LP, Harms HJ, Eiskj\u00e6r H, Mikkelsen F, Wiggers H, Andersen NF, Poulsen SH (2018) Myocardial oxygen consumption and efficiency in patients with cardiac amyloidosis. J Am Heart Assoc 7:e009974. https:\/\/doi.org\/10.1161\/jaha.118.009974","journal-title":"J Am Heart Assoc"},{"key":"3470_CR88","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/j.jacc.2016.06.053","volume":"68","author":"RH Falk","year":"2016","unstructured":"Falk RH, Alexander KM, Liao R, Dorbala SAL (2016) (Light-Chain) cardiac amyloidosis: A review of diagnosis and therapy. J Am Coll Cardiol 68:1323\u20131341. https:\/\/doi.org\/10.1016\/j.jacc.2016.06.053","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR89","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1002\/ehf2.14545","volume":"11","author":"S Rosengren","year":"2024","unstructured":"Rosengren S, Skibsted Clemmensen T, Hvitfeldt Poulsen S, Tolbod L, Harms HJ, Wikstr\u00f6m G, Kero T, Thyrsted Ladefoged B, S\u00f6rensen J (2024) Outcome prediction by myocardial external efficiency from (11) C-acetate positron emission tomography in cardiac amyloidosis. ESC Heart Fail 11:44\u201353. https:\/\/doi.org\/10.1002\/ehf2.14545","journal-title":"ESC Heart Fail"},{"issue":"1","key":"3470_CR90","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12968-019-0519-6","volume":"21","author":"M Gastl","year":"2019","unstructured":"Gastl M, Peereboom SM, Gotschy A, Fuetterer M, von Deuster C, Boenner F, Kelm M, Schwotzer R, Flammer AJ, Manka R et al (2019) Myocardial triglycerides in cardiac amyloidosis assessed by proton cardiovascular magnetic resonance spectroscopy. J Cardiovasc Magn Reson 21:10. https:\/\/doi.org\/10.1186\/s12968-019-0519-6","journal-title":"J Cardiovasc Magn Reson"},{"key":"3470_CR91","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1161\/01.cir.86.6.1810","volume":"86","author":"S Neubauer","year":"1992","unstructured":"Neubauer S, Krahe T, Schindler R, Horn M, Hillenbrand H, Entzeroth C, Mader H, Kromer EP, Riegger GA, Lackner K et al (1992) 31P magnetic resonance spectroscopy in dilated cardiomyopathy and coronary artery disease. Altered cardiac high-energy phosphate metabolism in heart failure. Circulation 86:1810\u20131818. https:\/\/doi.org\/10.1161\/01.cir.86.6.1810","journal-title":"Circulation"},{"issue":"Suppl O","key":"3470_CR92","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1093\/eurheartj\/16.suppl_o.115","volume":"16","author":"S Neubauer","year":"1995","unstructured":"Neubauer S, Horn M, Pabst T, G\u00f6dde M, L\u00fcbke D, Jilling B, Hahn D, Ertl G (1995) Contributions of 31P-magnetic resonance spectroscopy to the understanding of dilated heart muscle disease. Eur Heart J 16(Suppl O):115\u2013118. https:\/\/doi.org\/10.1093\/eurheartj\/16.suppl_o.115","journal-title":"Eur Heart J"},{"key":"3470_CR93","doi-asserted-by":"publisher","first-page":"2070","DOI":"10.1161\/01.cir.102.17.2070","volume":"102","author":"RS Beanlands","year":"2000","unstructured":"Beanlands RS, Nahmias C, Gordon E, Coates G, deKemp R, Firnau G, Fallen E (2000) The effects of beta(1)-blockade on oxidative metabolism and the metabolic cost of ventricular work in patients with left ventricular dysfunction: A double-blind, placebo-controlled, positron-emission tomography study. Circulation 102:2070\u20132075. https:\/\/doi.org\/10.1161\/01.cir.102.17.2070","journal-title":"Circulation"},{"key":"3470_CR94","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1253\/jcj.64.117","volume":"64","author":"T Ono","year":"2000","unstructured":"Ono T, Kohya T, Tsukamoto E, Mochizuki T, Itoh K, Itoh Y, Tomita F, Tamaki N, Kitabatake A (2000) Improvement in fatty acid utilization in relation to a change in left ventricular hypertrophy in spontaneously hypertensive rats. Jpn Circ J 64:117\u2013120. https:\/\/doi.org\/10.1253\/jcj.64.117","journal-title":"Jpn Circ J"},{"key":"3470_CR95","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1016\/j.jacc.2011.10.895","volume":"59","author":"GA Hirsch","year":"2012","unstructured":"Hirsch GA, Bottomley PA, Gerstenblith G, Weiss RG (2012) Allopurinol acutely increases adenosine triphospate energy delivery in failing human hearts. J Am Coll Cardiol 59:802\u2013808. https:\/\/doi.org\/10.1016\/j.jacc.2011.10.895","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR96","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.jchf.2014.09.009","volume":"3","author":"RM Beadle","year":"2015","unstructured":"Beadle RM, Williams LK, Kuehl M, Bowater S, Abozguia K, Leyva F, Yousef Z, Wagenmakers AJM, Thies F, Horowitz J et al (2015) Improvement in cardiac energetics by perhexiline in heart failure due to dilated cardiomyopathy. JACC: Heart Failure 3:202\u2013211. https:\/\/doi.org\/10.1016\/j.jchf.2014.09.009","journal-title":"JACC: Heart Failure"},{"key":"3470_CR97","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1016\/s0735-1097(03)00257-2","volume":"41","author":"B Nowak","year":"2003","unstructured":"Nowak B, Sinha AM, Schaefer WM, Koch KC, Kaiser HJ, Hanrath P, Buell U, Stellbrink C (2003) Cardiac resynchronization therapy homogenizes myocardial glucose metabolism and perfusion in dilated cardiomyopathy and left bundle branch block. J Am Coll Cardiol 41:1523\u20131528. https:\/\/doi.org\/10.1016\/s0735-1097(03)00257-2","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR98","first-page":"378","volume":"47","author":"O Lindner","year":"2006","unstructured":"Lindner O, S\u00f6rensen J, Vogt J, Fricke E, Baller D, Horstkotte D, Burchert W (2006) Cardiac efficiency and oxygen consumption measured with 11 C-acetate PET after long-term cardiac resynchronization therapy. J Nucl Med 47:378\u2013383","journal-title":"J Nucl Med"},{"key":"3470_CR99","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1007\/s00259-004-1631-9","volume":"31","author":"J Knuuti","year":"2004","unstructured":"Knuuti J, Sundell J, Naum A, Engblom E, Koistinen J, Ylitalo A, Stolen KQ, Kalliokoski R, Nekolla SG, Bax KE et al (2004) Assessment of right ventricular oxidative metabolism by PET in patients with idiopathic dilated cardiomyopathy undergoing cardiac resynchronization therapy. Eur J Nucl Med Mol Imaging 31:1592\u20131598. https:\/\/doi.org\/10.1007\/s00259-004-1631-9","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"3470_CR100","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.jacc.2003.10.044","volume":"43","author":"J Sundell","year":"2004","unstructured":"Sundell J, Engblom E, Koistinen J, Ylitalo A, Naum A, Stolen KQ, Kalliokoski R, Nekolla SG, Airaksinen KE, Bax JJ et al (2004) The effects of cardiac resynchronization therapy on left ventricular function, myocardial energetics, and metabolic reserve in patients with dilated cardiomyopathy and heart failure. J Am Coll Cardiol 43:1027\u20131033. https:\/\/doi.org\/10.1016\/j.jacc.2003.10.044","journal-title":"J Am Coll Cardiol"},{"key":"3470_CR101","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1093\/eurheartj\/ehab663","volume":"43","author":"JJ Rayner","year":"2021","unstructured":"Rayner JJ, Peterzan MA, Clarke WT, Rodgers CT, Neubauer S, Rider OJ (2021) Obesity modifies the energetic phenotype of dilated cardiomyopathy. Eur Heart J 43:868\u2013877. https:\/\/doi.org\/10.1093\/eurheartj\/ehab663","journal-title":"Eur Heart J"},{"key":"3470_CR102","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1042\/cs0990027","volume":"99","author":"S Schmidt-Schweda","year":"2000","unstructured":"Schmidt-Schweda S, Holubarsch C (2000) First clinical trial with etomoxir in patients with chronic congestive heart failure. Clin Sci 99:27\u201335. https:\/\/doi.org\/10.1042\/cs0990027","journal-title":"Clin Sci"},{"key":"3470_CR103","doi-asserted-by":"publisher","unstructured":"Lee L, Campbell R, Scheuermann-Freestone M, Taylor R, Gunaruwan P, Williams L, Ashrafian H, Horowitz J, Fraser AG, Clarke K, (2005) et al (2005) Metabolic modulation with perhexiline in chronic heart failure. Circulation 112:3280\u20133288. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.105.551457","DOI":"10.1161\/CIRCULATIONAHA.105.551457"},{"key":"3470_CR104","doi-asserted-by":"publisher","first-page":"3218","DOI":"10.1161\/CIRCULATIONAHA.105.581819","volume":"112","author":"DA Morrow","year":"2005","unstructured":"Morrow DA, Givertz MM (2005) Modulation of myocardial energetics. Circulation 112:3218\u20133221. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.105.581819","journal-title":"Circulation"},{"key":"3470_CR105","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1177\/1089253206291150","volume":"10","author":"GD Lopaschuk","year":"2006","unstructured":"Lopaschuk GD (2006) Optimizing cardiac fatty acid and glucose metabolism as an approach to treating heart failure. Semin Cardiothorac Vasc Anesth 10:228\u2013230. https:\/\/doi.org\/10.1177\/1089253206291150","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"3470_CR106","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1161\/01.Cir.0000139339.85840.Dd","volume":"110","author":"LA Nikolaidis","year":"2004","unstructured":"Nikolaidis LA, Elahi D, Hentosz T, Doverspike A, Huerbin R, Zourelias L, Stolarski C, Shen YT, Shannon RP (2004) Recombinant glucagon-like peptide-1 increases myocardial glucose uptake and improves left ventricular performance in conscious dogs with pacing-induced dilated cardiomyopathy. Circulation 110:955\u2013961. https:\/\/doi.org\/10.1161\/01.Cir.0000139339.85840.Dd","journal-title":"Circulation"},{"key":"3470_CR107","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1161\/hc0202.102238","volume":"105","author":"G Hasenfuss","year":"2002","unstructured":"Hasenfuss G, Maier LS, Hermann HP, L\u00fcers C, H\u00fcnlich M, Zeitz O, Janssen PM, Pieske B (2002) Influence of pyruvate on contractile performance and Ca(2+) cycling in isolated failing human myocardium. Circulation 105:194\u2013199. https:\/\/doi.org\/10.1161\/hc0202.102238","journal-title":"Circulation"},{"key":"3470_CR108","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4095","volume":"32","author":"J Ellis","year":"2019","unstructured":"Ellis J, Valkovi\u010d L, Purvis LAB, Clarke WT, Rodgers CT (2019) Reproducibility of human cardiac phosphorus MRS ((31)P-MRS) at 7 T. NMR Biomed 32:e4095. https:\/\/doi.org\/10.1002\/nbm.4095","journal-title":"NMR Biomed"},{"key":"3470_CR109","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1002\/mrm.24922","volume":"72","author":"CT Rodgers","year":"2014","unstructured":"Rodgers CT, Clarke WT, Snyder C, Vaughan JT, Neubauer S, Robson MD (2014) Human cardiac 31P magnetic resonance spectroscopy at 7 tesla. Magn Reson Med 72:304\u2013315. https:\/\/doi.org\/10.1002\/mrm.24922","journal-title":"Magn Reson Med"},{"key":"3470_CR110","doi-asserted-by":"publisher","first-page":"19773","DOI":"10.1073\/pnas.0706235104","volume":"104","author":"ME Merritt","year":"2007","unstructured":"Merritt ME, Harrison C, Storey C, Jeffrey FM, Sherry AD, Malloy CR (2007) Hyperpolarized 13\u00a0C allows a direct measure of flux through a single enzyme-catalyzed step by NMR. Proc Natl Acad Sci U S A 104:19773\u201319777. https:\/\/doi.org\/10.1073\/pnas.0706235104","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"3","key":"3470_CR111","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.5074","volume":"37","author":"HY Chen","year":"2024","unstructured":"Chen HY, Gordon JW, Dwork N, Chung BT, Riselli A, Sivalokanathan S, Bok RA, Slater JB, Vigneron DB, Abraham MR et al (2024) Probing human heart TCA cycle metabolism and response to glucose load using hyperpolarized [2-(13)c]pyruvate MRS. NMR Biomed 37(3):e5074. https:\/\/doi.org\/10.1002\/nbm.5074","journal-title":"NMR Biomed"},{"key":"3470_CR112","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1161\/circresaha.116.309769","volume":"119","author":"CH Cunningham","year":"2016","unstructured":"Cunningham CH, Lau JY, Chen AP, Geraghty BJ, Perks WJ, Roifman I, Wright GA, Connelly KA (2016) Hyperpolarized 13 C metabolic MRI of the human heart: initial experience. Circ Res 119:1177\u20131182. https:\/\/doi.org\/10.1161\/circresaha.116.309769","journal-title":"Circ Res"},{"key":"3470_CR113","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1161\/CIRCRESAHA.116.309769","volume":"119","author":"CH Cunningham","year":"2016","unstructured":"Cunningham CH, Lau JYC, Chen AP, Geraghty BJ, Perks WJ, Roifman I, Wright GA, Connelly KA (2016) Hyperpolarized\u2009<\u2009sup\u2009>\u200913\u00a0C metabolic MRI of the human heart. Circul Res 119:1177\u20131182. https:\/\/doi.org\/10.1161\/CIRCRESAHA.116.309769","journal-title":"Circul Res"},{"key":"3470_CR114","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1161\/CIRCIMAGING.114.002648","volume":"7","author":"GD Aquaro","year":"2014","unstructured":"Aquaro GD, Menichetti L (2014) Hyperpolarized 13 C-magnetic resonance spectroscopy. Circ Cardiovasc Imaging 7:854\u2013856. https:\/\/doi.org\/10.1161\/CIRCIMAGING.114.002648","journal-title":"Circ Cardiovasc Imaging"},{"key":"3470_CR115","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1002\/mrm.28717","volume":"86","author":"HM De Feyter","year":"2021","unstructured":"De Feyter HM, Thomas MA, Behar KL, de Graaf RA (2021) NMR visibility of deuterium-labeled liver glycogen in vivo. Magn Reson Med 86:62\u201368. https:\/\/doi.org\/10.1002\/mrm.28717","journal-title":"Magn Reson Med"},{"key":"3470_CR116","doi-asserted-by":"publisher","first-page":"2899","DOI":"10.1002\/mrm.28914","volume":"86","author":"T Wang","year":"2021","unstructured":"Wang T, Zhu XH, Li H, Zhang Y, Zhu W, Wiesner HM, Chen W (2021) Noninvasive assessment of myocardial energy metabolism and dynamics using in vivo deuterium MRS imaging. Magn Reson Med 86:2899\u20132909. https:\/\/doi.org\/10.1002\/mrm.28914","journal-title":"Magn Reson Med"},{"key":"3470_CR117","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3390\/medicina59010174","volume":"59","author":"V Tsampasian","year":"2023","unstructured":"Tsampasian V, Cameron D, Sobhan R, Bazoukis G, Vassiliou VS (2023) Phosphorus magnetic resonance spectroscopy (31P MRS) and cardiovascular disease: the importance of energy. Medicina (Kaunas) 59:174","journal-title":"Medicina (Kaunas)"},{"key":"3470_CR118","doi-asserted-by":"publisher","first-page":"e015316","DOI":"10.1161\/JAHA.119.015316","volume":"9","author":"RY Parbhudayal","year":"2020","unstructured":"Parbhudayal RY, Harms HJ, Michels M, van Rossum AC, Germans T, van der Velden J (2020) Increased myocardial oxygen consumption precedes contractile dysfunction in hypertrophic cardiomyopathy caused by Pathogenic\u2009<\u2009i\u2009>\u2009TNNT2\u2009Gene variants. J Am Heart Association 9:e015316. https:\/\/doi.org\/10.1161\/JAHA.119.015316","journal-title":"J Am Heart Association"}],"container-title":["The International Journal of Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-025-03470-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10554-025-03470-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-025-03470-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:16:04Z","timestamp":1759382164000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10554-025-03470-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":118,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["3470"],"URL":"https:\/\/doi.org\/10.1007\/s10554-025-03470-2","relation":{},"ISSN":["1875-8312"],"issn-type":[{"value":"1875-8312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"assertion":[{"value":"4 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Marco Guglielmo has received a speaker fee from Circle Cardiovascular Imaging. Anneline te Riele is a consultant for Bristol Meyers Squibb, Tenaya Therapeutics and Rocket Pharmaceuticals for unrelated work. Anneline te Riele is supported by ZonMW grants (2020 Off Road; project number 04510012010041; and 2024 Clinical Fellows; project number 09032232310042).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The manuscript does not contain clinical studies or patient data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}