Key result
Patients with mild heart failure with preserved ejection fraction had a 2.3-fold higher myocardial triglyceride content compared to healthy controls.
Why the study?
Does myocardial triglyceride accumulation and altered energetics correlate with impaired diastolic strain rate and exercise capacity in patients with mild HFpEF?
Cross-Sectional (n=41)
No
Does myocardial triglyceride accumulation and altered energetics correlate with impaired diastolic strain rate and exercise capacity in patients with mild HFpEF?
Absolute Event Rate: 1.45% vs 0.64%
p-value: p=0.009
Myocardial steatosis is pronounced in mild HFpEF and independently correlates with impaired diastolic strain rate, suggesting a pathophysiological role of altered metabolism in exercise intolerance.
Supports steatosis-diastolic dysfunction link in mild HFpEF; leaves open causal role and therapeutic targeting.
BACKGROUND: Heart failure (HF) is characterized by altered myocardial substrate metabolism which can lead to myocardial triglyceride accumulation (steatosis) and lipotoxicity. However its role in mild HF with preserved ejection fraction (HFpEF) is uncertain. We measured myocardial triglyceride content (MTG) in HFpEF and assessed its relationships with diastolic function and exercise capacity. METHODS: P-CMRS to measure myocardial energetics (phosphocreatine-to-adenosine triphosphate - PCr/ATP) and feature-tracking cardiovascular magnetic resonance (CMR) imaging for diastolic strain rate. RESULTS: max. CONCLUSIONS: Myocardial steatosis is pronounced in mild HFpEF, and is independently associated with impaired diastolic strain rate which is itself related to exercise capacity. Steatosis may adversely affect exercise capacity by indirect effect occurring via impairment in diastolic function. As such, myocardial triglyceride may become a potential therapeutic target to treat the increasing number of patients with HFpEF.
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Mahmod et al. (2018) conducted a cross-sectional in Mild heart failure with preserved ejection fraction (HFpEF) (n=41). Mild HFpEF (Exposure) vs. Healthy controls was evaluated on Myocardial triglyceride content (lipid/water, %) (p=0.009). Patients with mild heart failure with preserved ejection fraction had a 2.3-fold higher myocardial triglyceride content compared to healthy controls.
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