{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:33Z","timestamp":1792785873267,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["519332007"],"award-info":[{"award-number":["519332007"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004040","name":"KU Leuven","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EU Horizon"},{"DOI":"10.13039\/501100003130","name":"Research Foundation Flanders","doi-asserted-by":"publisher","award":["12ZZN22N"],"award-info":[{"award-number":["12ZZN22N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Research Foundation Flanders","doi-asserted-by":"publisher","award":["1832917N"],"award-info":[{"award-number":["1832917N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In dyssynchronous heart failure (DHF), left bundle branch block (LBBB) causes inhomogeneous left ventricular (LV) workload and systolic dysfunction. We aimed to investigate underlying metabolic remodelling in an ovine model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Eleven sheep with dual-chamber-pacemakers for LBBB-like activation (DHF) were studied at baseline and after eight weeks. Six untreated sheep served as controls (CTRL). Regional workload was evaluated using invasive hemodynamics and echocardiography. 18F-fluorodeoxyglucose-tracer positron-emission-tomography\/computed tomography visualized regional glucose-uptake. Magnetic resonance imaging assessed LV morphology and function. Septal and lateral wall tissue was analysed with histology, confocal microscopy, ultra-high-performance liquid chromatography-high resolution mass-spectrometry (UHPLC-HRMS). Dyssynchrony induced low septal and high lateral asymmetry in workload and glucose-uptake. After 8 weeks, DHF animals exhibited LV dilation and LVEF decline (31.1 \u00b1 5.1% vs. 59.4 \u00b1 3.5% at baseline, P &amp;lt; .05). Septal thinning and lateral hypertrophy rebalanced workload and glucose-uptake. No fibrosis was seen on histology. DHF-animals showed enrichment of mitochondria at the intercalated discs (EMID-sign)\u2014highest in the lateral wall (DHF septal 7.0 \u00b1 4.8% vs. lateral 48.4 \u00b1 12.3%, P &amp;lt; .05). Mitochondrial redox balance in DHF shifted towards a more oxidized state without evidence of oxidative stress. Metabolomics revealed no differences between septal and lateral walls but severe energy depletion of tricarboxylic acid cycle substrates and phosphocreatine in DHF (fold change DHF\/CTRL 0.01, P &amp;lt; .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Experimental DHF is characterized by non-fibrotic, dilated LV without signs of oxidative stress. Workload increase in the lateral wall leads to hypertrophy and EMID, homogenizing metabolic profiles between wall segments. However, the ventricle enters energy starvation and systolic dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag112","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:44:40Z","timestamp":1775735080000},"source":"Crossref","is-referenced-by-count":2,"title":["Dyssynchronous heart failure: mitochondrial distribution and functions mirror regional workload and energy demand in a large-animal model of ventricular desynchronization"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-8620","authenticated-orcid":false,"given":"Alexander","family":"Dietl","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg D-93042 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Iberl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital 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,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9413-885X","authenticated-orcid":false,"given":"Michael","family":"Paulus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg D-93042 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Riehle","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9471-1166","authenticated-orcid":false,"given":"Stefan","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg D-93042 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Z\u00fcgner","sequence":"additional","affiliation":[{"name":"Joanneum Research Health , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars S","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg D-93042 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Rega","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Cardiothoracic Surgery, University Hospitals Leuven , Leuven 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