Dietary Fat, Sugar Consumption, and Cardiorespiratory Fitness in Patients With Heart Failure With Preserved Ejection Fraction

Carbone, Salvatore; Canada, Justin M.; Buckley, Leo F.; Trankle, Cory R.; Billingsley, Hayley; Dixon, Dave L.; Mauro, Adolfo G; Dessie, Sofanit; Kadariya, Dinesh; Mezzaroma, Eleonora; Buzzetti, Raffaella; Arena, Ross; Tassell, Benjamin Van; Toldo, Stefano; Abbate, Antonio

doi:10.1016/j.jacbts.2017.06.009

Cited by 60 publications

(38 citation statements)

References 46 publications

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“…HFpEF and very low NT-proBNP levels 375 retain a high degree of relevance for population of patients with HFpEF as obesity is an important and highly prevalent co-morbidity in this group. 24 These data, however, do not support elimination of NP assessment as part of routine management of HFpEF patients. Indeed, NPs remain strong markers of LV wall stress 25 and prognosis.…”

Section: Figurementioning

confidence: 96%

Low NT‐proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction

et al. 2018

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BackgroundHeart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that presents clinicians with a diagnostic challenge. The use of natriuretic peptides to exclude a diagnosis of HFpEF has been proposed. We sought to compare HFpEF patients with N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) level above and below the proposed cut‐off.MethodsStable patients (n = 30) with left ventricular (LV) ejection fraction ≥ 50% were eligible if they had a diagnosis of HF according to the European Society of Cardiology diagnostic criteria. Characteristics of patients with NT‐proBNP below (≤125 pg/mL) and above (>125 pg/mL) the diagnostic criterion were compared.ResultsThere were 19 (66%) women with median age 54 years. Half were African American (16, 53%), and most were obese. There were no significant differences in clinical characteristics or medication use between groups. LV end‐diastolic volume index was greater in high NT‐proBNP patients (P = 0.03). Left atrial volume index, E/e′ ratio, and E/e′ ratio at peak exercise were not significantly different between NT‐proBNP groups. Peak oxygen consumption (VO2), VO2 at ventilatory threshold, and ventilatory efficiency measures were impaired in all patients and were not significantly different between high and low NT‐proBNP patients.ConclusionsNT‐proBNP was below the proposed diagnostic cut‐off point of 125 pg/mL in half of this obese study cohort. Cardiac diastolic dysfunction and cardiorespiratory fitness were not significantly different between high and low NT‐proBNP patients. These data indicate that excluding the diagnosis of HFpEF based solely on NT‐proBNP levels should be discouraged.

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Section: Figurementioning

confidence: 96%

Low NT‐proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction

et al. 2018

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“…A high‐fat diet can be divided into high‐unsaturated fat diet and high‐saturated fat diet. Data from clinical and preclinical studies showed that a high‐unsaturated fat diet consumption is related with an improved body composition and cardiac diastolic function in obese patients with heart failure with preserved ejection fraction (HFpEF), and in obese mice . Our previous studies have shown that 12 weeks of HFD consumption caused obese‐insulin resistance in rats .…”

Section: Introductionmentioning

confidence: 99%

High‐Saturated Fat High‐Sugar Diet Accelerates Left‐Ventricular Dysfunction Faster than High‐Saturated Fat Diet Alone via Increasing Oxidative Stress and Apoptosis in Obese‐Insulin Resistant Rats

Apaijai

Arinno

Palee

et al. 2018

Molecular Nutrition Food Res

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Scope It has been hypothesized that a high‐saturated‐fat, high‐sugar diet (HFHS) causes worse cardiometabolic dysfunction than a high‐saturated‐fat diet (HFD) due to severe mitochondrial dysfunction, oxidative stress, and apoptosis in obese insulin‐resistant rats. Methods and Results Rats are divided into three groups to receive normal diet (ND), HFD, or HFHS for 24 weeks. Cardiometabolic parameters are determined at baseline and every 4 weeks until the end of the feeding protocol. At week 24, hearts are removed to determine mitochondrial function and dynamics, apoptosis, and insulin signaling. HFD and HFHS rats develop obese insulin‐resistance at week 8. However, fasting plasma glucose level is increased only in HFHS rats. Myocardial insulin signaling is markedly impaired in HFHS rats compared to other groups. Cardiac autonomic imbalance is observed in both HFD and HFHS rats beginning at week 8. However, cardiac dysfunction is observed earlier (week 8) in HFHS rats, and later at week 12 in HFD rats. Moreover, cardiac and mitochondrial oxidative stress levels, and apoptosis are greater in HFHS rats than HFD rats. Conclusion Both HFD and HFHS cause cardiometabolic dysfunction. HFHS causes more severe metabolic disturbance, oxidative stress, and apoptosis than HFD, which leads to an accelerated LV dysfunction in HFHS rats.

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“…Dietary sodium intake can affect fluid status and RAAS activation; therefore, we estimated sodium intake using a standardized 5-pass interview 24-hour dietary recall, as previously described. 10 Body weight and waist circumference were measured on the day of RAAS activation assessment. Waist circumference was measured according to the World Health Organization recommendations.…”

Section: Dietary Sodium Body Weight and Waist Circumference Assessmentioning

confidence: 99%

Effects of empagliflozin on cardiorespiratory fitness and significant interaction of loop diuretics

Carbone

Canada

Billingsley

et al. 2018

Diabetes Obesity Metabolism

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The effects of empagliflozin on cardiorespiratory fitness in patients with type 2 diabetes mellitus (T2DM) and heart failure with reduced ejection fraction (HFrEF) are unknown. In this pilot study we determined the effects of empagliflozin 10 mg/d for 4 weeks on peak oxygen consumption (VO ) in 15 patients with T2DM and HFrEF. As an exploratory analysis, we assessed whether there was an interaction of the effects of empagliflozin on peak VO of loop diuretics. Empagliflozin reduced body weight (-1.7 kg; P = .031), but did not change peak VO (from 14.5 mL kg min [12.6-17.8] to 15.8 [12.5-17.4] mL kg min ; P = .95). However, patients using loop diuretics (N = 9) demonstrated an improvement, whereas those without loop diuretics (N = 6) experienced a decrease in peak VO (+0.9 [0.1-1.4] vs -0.9 [-2.1 to -0.3] mL kg min ; P = .001), and peak VO changes correlated with the baseline daily dose of diuretics (R = +0.83; P < .001). Empagliflozin did not improve peak VO in patients with T2DM and HFrEF. However, as a result of exploratory analysis, patients concomitantly treated with loop diuretics experienced a significant improvement in peak VO .

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Dietary Fat, Sugar Consumption, and Cardiorespiratory Fitness in Patients With Heart Failure With Preserved Ejection Fraction

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Cited by 60 publications

References 46 publications

Low NT‐proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction

Low NT‐proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction

High‐Saturated Fat High‐Sugar Diet Accelerates Left‐Ventricular Dysfunction Faster than High‐Saturated Fat Diet Alone via Increasing Oxidative Stress and Apoptosis in Obese‐Insulin Resistant Rats

Effects of empagliflozin on cardiorespiratory fitness and significant interaction of loop diuretics

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