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

Fri, 2016-06-24 12:02 -- voskuhlt
TitleAltered Metabolic Profile With Sodium-Restricted Dietary Approaches to Stop Hypertension Diet in Hypertensive Heart Failure With Preserved Ejection Fraction.
Publication TypeJournal Article
Year of Publication2015
AuthorsMathew AV, E Seymour M, Byun J, Pennathur S, Hummel SL
JournalJ Card Fail
Volume21
Issue12
Pagination963-7
Date Published2015 Dec
ISSN1532-8414
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.

DOI10.1016/j.cardfail.2015.10.003
Alternate JournalJ. Card. Fail.
PubMed ID26497755
PubMed Central IDPMC4720261
Grant ListDK081943 / DK / NIDDK NIH HHS / United States
DK089503 / DK / NIDDK NIH HHS / United States
DK097153 / DK / NIDDK NIH HHS / United States
HL1091976 / HL / NHLBI NIH HHS / United States
K23 HL109176 / HL / NHLBI NIH HHS / United States
R21 AG047939 / AG / NIA NIH HHS / United States
UL1TR000433 / TR / NCATS NIH HHS / United States