Heart failure treatment and serum carnitines in HFpEF and HFrEF with or without hypertension - a pilot study

IF 4.3 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Hypertension Research Pub Date : 2025-01-16 DOI:10.1038/s41440-025-02106-1

Haruhito Harada, Yasuhiro Nishiyama, Atsushi Katoh, Hiroshi Niiyama, Akihiro Iwaki, Yusuke Ohchi, Motoki Sasaki, Yuji Aoki, Norihito Okina, Hisashi Kai

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Abstract

The ratio of serum acylcarnitines to free carnitines (AC/FC) reflects impaired cardiomyocyte β-oxidization. The effect of heart failure (HF) treatment on AC/FC remained unclear. This pilot study retrospectively examined treatment-induced AC/FC changes in patients with HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) in 148 consecutive inpatients undergoing echocardiography and carnitine measurement at admission and discharge. Symptomatic ACCF/AHA HF stage C/D patients (HFpEF, n = 40; HErEF, n = 24) received standard medical therapy and comprehensive cardiac rehabilitation. At admission, AC/FC levels in HFpEF and HFrEF were significantly higher than in asymptomatic stage A/B (n = 84), decreasing to comparable levels at discharge. AC/FC reduction was associated with improvement of left ventricular ejection fraction through HF treatment in HFpEF, particularly in HFpEF with hypertension, but not in HFrEF. Large-scale, multicenter prospective studies with precise cardiac function assessments are essential to validate the preliminary findings and to clarify the underlying pathophysiological mechanisms.

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伴有或不伴有高血压的HFpEF和HFrEF患者的心力衰竭治疗和血清肉碱-一项初步研究。

血清酰基肉碱与游离肉碱的比值（AC/FC）反映心肌细胞β-氧化受损。心力衰竭（HF）治疗对AC/FC的影响尚不清楚。本初步研究回顾性研究了148例连续住院患者，在入院和出院时接受超声心动图和肉碱测量的保留射血分数（HFpEF）和降低射血分数（HFrEF）的HF患者中治疗引起的AC/FC变化。有症状的ACCF/AHA HF C/D期患者(HFpEF, n = 40；HErEF, n = 24)接受标准药物治疗和综合心脏康复。入院时，HFpEF和HFrEF的AC/FC水平显著高于无症状A/B期（n = 84），出院时降至可比水平。通过HF治疗HFpEF患者，特别是合并高血压的HFpEF患者，AC/FC降低与左室射血分数的改善相关，但与HFrEF患者无关。大规模、多中心的前瞻性研究和精确的心功能评估对于验证初步发现和阐明潜在的病理生理机制至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hypertension Research 医学-外周血管病

CiteScore

7.40

自引率

16.70%

发文量

249

审稿时长

3-8 weeks

期刊介绍： Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.