{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T18:04:26Z","timestamp":1768932266527,"version":"3.49.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2012,7,1]],"date-time":"2012-07-01T00:00:00Z","timestamp":1341100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The goal of the study was to examine whether resting or post-exercise metabolic substrate levels are associated with differential exercise performance and long-term outcome in control subjects or heart failure (HF) patients with or without type 2 diabetes mellitus (DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Twenty five healthy controls matched with 97 patients with stable advanced HF were prospectively enrolled. Exercise capacity, age, gender, and HF aetiology were balanced between HFDM\u2013 and HFDM+ groups. Subjects underwent maximal bicycle spiroergometry with blood sampling to measure metabolites and neurohormones before and immediately after the exercise. HFDM+ patients had increased free fatty acids, glucose, and \u03b2-hydroxybutyrate compared with controls. HFDM+ patients had higher baseline copeptin (24 \u00b1 16 vs. 17 \u00b1 13 pmol\/L, P &amp;lt; 0.05) but otherwise showed similar neurohumoral activation and exercise response to HFDM\u2013 patients. Peak oxygen consumption (VO2) was unrelated to post-exercise free fatty acids, glucose, lactate, or glycerol, but strongly correlated with post-exercise pyruvate (in all: r = 0.62, P &amp;lt; 0.001). During the next 17 \u00b1 10 months, 36% of HF patients experienced an adverse event (death, urgent transplantation, or assist device insertion). From metabolic factors, only post-exercise glucose [hazard ratio (HR) 1.28, P = 0.04), total body fat (HR 0.58, P &amp;lt; 0.001), and the presence of DM (HR 1.98, P = 0.04) were predictive of the outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With the exception of pyruvate, acute changes of metabolic substrates are not related to cardiac performance in HF, regardless of diabetic status. Inhibition of body fat depletion, attenuation of stress-related hyperglycaemia, or increasing dynamics of plasma pyruvate may represent therapeutic targets in advanced HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfs080","type":"journal-article","created":{"date-parts":[[2012,6,13]],"date-time":"2012-06-13T20:35:08Z","timestamp":1339619708000},"page":"754-763","source":"Crossref","is-referenced-by-count":12,"title":["Availability of Energetic Substrates and Exercise Performance in Heart Failure With or Without Diabetes"],"prefix":"10.1093","volume":"14","author":[{"given":"Vojtech","family":"Melenovsky","sequence":"first","affiliation":[{"name":"Department of Cardiology, Institute of Clinical and Experimental Medicine\u2013IKEM , Prague 4, 140 28 ,","place":["Czech Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Kotrc","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Clinical 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