Altered Metabolic Profile With Sodium-Restricted Dietary Approaches to Stop Hypertension Diet in Hypertensive Heart Failure With Preserved Ejection Fraction
Open accessAbstract
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.
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Self-citation
- Authors
- Mathew, A. V., Seymour, E. M., Byun, J., Pennathur, S., & Hummel, S. L.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Hummel, Scott L.
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 21
- Issue
- 12
- Pages
- 963-967
- ISSN
- 1071-9164 (ISSN-L)
- PMC
- PMC4720261
- OpenAlex
- W2190421574
- Cited by
- 48
- References
- 16
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 4 · 2016: 4 · 2015: 1
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (HL1091976, DK089503, DK097153, DK081943, UL1TR000433)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- heart failure with preserved ejection fraction, DASH diet, sodium restriction, metabolomics, propionylcarnitine, L-carnitine, ventricular-arterial coupling, ventricular contractility, ventricular stiffness, energy substrate utilization, myocardial function, hypertension
- MeSH terms
- Adult, Aged, Chromatography, Diet, Sodium-Restricted, Female, Humans, Hypertension, Male, Middle Aged, Pilot Projects, Prognosis, Sampling Studies, Severity of Illness Index, Mass Spectrometry, Stroke Volume, Echocardiography, Doppler, Incidence, Age Distribution, Sex Distribution, Risk Assessment, Heart Failure, Diastolic, Metabolome
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