Altered Metabolic Profile With Sodium-Restricted Dietary Approaches to Stop Hypertension Diet in Hypertensive Heart Failure With Preserved Ejection Fraction.

Abstract

BACKGROUND:

Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a distinct entity with unique pathophysiology. In the Dietary Approaches to Stop Hypertension in Diastolic Heart Failure (DASH-DHF) study, the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) was associated with improved blood pressure and cardiovascular function in 13 hypertensive patients with HFpEF. With the use of targeted metabolomics, we explored metabolite changes and their relationship with energy-dependent measures of cardiac function in DASH-DHF.

METHODS AND RESULTS:

With the use of chromatography and mass spectrometry, 152 metabolites including amino acids, free fatty acids, phospholipids, diglycerides, triglycerides, cholesterol esters, and acyl carnitines were measured. Comparison of baseline and post-DASH/SRD samples revealed increases in short-chain acetyl, butryl, and propionyl carnitines (P values .02, .03, .03, respectively). Increases in propionyl carnitine correlated with ventricular-arterial coupling ratio (Ees:Ea; r = 0.78; P = .005) and ventricular contractility (maximum rate of change of pressure-normalized stress [dσ*/dtmax]; r = 0.66; P = .03). Changes in L-carnitine also correlated with Ees:Ea (r = 0.62; P = .04) and dσ*/dtmax (r = 0.60; P = .05) and inversely with ventricular stiffness (r = -0.63; P = .03).

CONCLUSIONS:

Metabolite profile changes of patients with HFpEF during dietary modification with the use of DASH/SRD suggest improved energy substrate utilization. Additional studies are needed to clarify connections between diet, metabolic changes, and myocardial function in HFpEF.

• Authors: Anna V Mathew, E Mitchell Seymour, Jaeman Byun, Subramaniam Pennathur, Scott L Hummel
• Journal: Journal of cardiac failure (J Card Fail) Vol. 21 Issue 12 Pg. 963-7 (Dec 2015) ISSN: 1532-8414 [Electronic] United States
• PMID: 26497755 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Published by Elsevier Inc.

Topics

• Adult
• Age Distribution
• Aged
• Chromatography (methods)
• Diet, Sodium-Restricted
• Echocardiography, Doppler
• Female
• Heart Failure, Diastolic (blood, diagnostic imaging, diet therapy, epidemiology, physiopathology)
• Humans
• Hypertension (diet therapy, epidemiology, physiopathology)
• Incidence
• Male
• Mass Spectrometry (methods)
• Metabolome (physiology)
• Middle Aged
• Pilot Projects
• Prognosis
• Risk Assessment
• Sampling Studies
• Severity of Illness Index
• Sex Distribution
• Stroke Volume (physiology)