Tentative bottom line: ATP synthase dimer angles could become a powerful structural biomarker of mitochondrial health.
If cardiolipin composition influences ATP synthase geometry, and that geometry influences cristae architecture, measuring dimer angles could provide a readout of mitochondrial structural integrity that conventional protein-abundance measurements miss.
The 2025 study makes this particularly interesting: simulated healthy cardiolipin membranes produced ATP synthase dimer angles of approximately 73° versus 65° in Barth syndrome-like membranes.