Key result
Patients discharged after hospitalization for acute heart failure with low ejection fraction had significantly increased myocardial unsaturated fatty acid content compared to controls (0.79% vs 0.14%, p=0.02).
Why the study?
Does myocardial triglyceride content measured by 3T CMR correlate with left ventricular systolic function in patients recovering from acute heart failure?
Cross-Sectional (n=71)
No
Does myocardial triglyceride content measured by 3T CMR correlate with left ventricular systolic function in patients recovering from acute heart failure?
Absolute Event Rate: 0.79% vs 0.14%
p-value: p=0.02
Increased myocardial unsaturated fatty acid content measured by 3T CMR is associated with worse left ventricular ejection fraction and increased LV mass in patients recovering from acute heart failure.
Elevated myocardial UFA was associated with worse LV function post-acute HF; leaves open whether 1H-MRS aids outcome prediction.
BACKGROUND: Increased myocardial triglyceride (TG) content has been recognized as a risk factor for cardiovascular disease. However, its relation with cardiac function in patients on recovery from acute heart failure (HF) remains unclear. In this cross-sectional study, we sought to investigate the association between myocardial TG content measured on magnetic resonance spectroscopy ((1)H-MRS) and left ventricular (LV) function assessed on cardiovascular magnetic resonance (CMR) in patients who were hospitalized with HF. METHODS: A total of 50 patients who were discharged after hospitalization for acute HF and 21 age- and sex-matched controls were included in the study. Myocardial TG content and LV parameters (function and mass) were measured on a 3.0 T MR scanner. Fatty acid (FA) and unsaturated fatty acid (UFA) content was normalized against water (W) using the LC-Model algorithm. The patient population was dichotomized according to the left ventricular ejection fraction (LVEF, <50% or ≥ 50%). RESULTS: H-MRS data were available for 48 patients and 21 controls. Of the 48 patients, 25 had a LVEF <50% (mean, 31.2%), whereas the remaining 23 had a normal LVEF (mean, 60.2%). Myocardial UFA/W ratio was found to differ significantly in patients with low LVEF, normal LVEF, and controls (0.79% vs. 0.21% vs. 0.14%, respectively, p = 0.02). The myocardial UFA/TG ratio was associated with LV mass (r = 0.39, p < 0.001) and modestly related to LV end-diastolic volume (LVEDV; r = 0.24, p = 0.039). We also identified negative correlations of the myocardial FA/TG ratio with both LV mass (r = -0.39, p < 0.001) and LVEDV (r = -0.24, p = 0.039). CONCLUSIONS: As compared with controls, patients who were discharged after hospitalization for acute HF had increased myocardial UFA content; furthermore, UFA was inversely related with LVEF, LV mass and, to a lesser extent, LVEDV. Our study may stimulate further research on the measure of myocardial UFA content by (1)H-MRS for outcome prediction. TRIAL REGISTRATION: ClinicalTrial.gov: NCT02378402 . Registered 27/02/2015.
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Liao et al. (2016) conducted a cross-sectional in Acute heart failure (n=71). Myocardial unsaturated fatty acid (UFA) content vs. Healthy controls was evaluated on Myocardial UFA/W (unsaturated fatty acid to water) ratio (p=0.02). Patients discharged after hospitalization for acute heart failure with low ejection fraction had significantly increased myocardial unsaturated fatty acid content compared to controls (0.79% vs 0.14%, p=0.02).
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