Key result
Low free carnitine (≤40.18 μmol/L) was associated with poorer survival in HFpEF, whereas higher levels (≥35.67 μmol/L) were linked to poorer outcomes in HFrEF.
Why the study?
HFpEF lacks effective treatments, and understanding differences in metabolic profiles between HFpEF and HFrEF patients is crucial for therapeutic advancements.
Do circulating free carnitine levels differentially associate with the composite risk of cardiac events in patients with HFpEF versus HFrEF?
Cohort (n=3,882)
Do circulating free carnitine levels differentially associate with the composite risk of cardiac events in patients with HFpEF versus HFrEF?
Circulating free carnitine levels have distinct prognostic implications in HFpEF (where low levels predict poor survival) versus HFrEF (where high levels predict poor outcomes), highlighting different metabolic pathways.
Distinct metabolic profiles in HFpEF vs HFrEF may inform subtype-specific therapies; hypothesis-generating and requires prospective validation.
Heart failure (HF) is a global concern, particularly HF with preserved ejection fraction (HFpEF), lacking effective treatments. Understanding the differences of metabolic profiles between HFpEF and HFrEF (heart failure with reduced ejection fraction) patients is crucial for therapeutic advancements. In this study, pseudotargeted metabolomics was employed to analyze for disparities of plasma metabolic profiles between HFpEF and HFrEF in two cohorts: discovery ( n = 514) and validation ( n = 3368). Plasma-free carnitine levels were significant changed in HF patients. A non-linear and U-shaped (for HFpEF) or J-shaped (for HFrEF) association between circulating free carnitine levels and the composite risk of cardiac events were observed. Interestingly, HFpEF patients with low free carnitine (≤40.18 μmol/L) displayed a poorer survival, contrasting with HFrEF where higher levels (≥35.67 μmol/L) were linked to poorer outcomes, indicating distinct metabolism pathways. In conclusion, these findings offer insights into HFpEF metabolic profiles, suggesting potential therapeutic targets.
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Wang et al. (2024) conducted a cohort in Heart failure (HFpEF and HFrEF) (n=3,882). Plasma-free carnitine levels was evaluated on Composite risk of cardiac events. Low free carnitine (≤40.18 μmol/L) was associated with poorer survival in HFpEF, whereas higher levels (≥35.67 μmol/L) were linked to poorer outcomes in HFrEF.
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