射血分数保留的心力衰竭患者的饱和脂肪酸血水平与心脏代谢表型：醛固酮 - 舒张性心力衰竭试验的二次分析
Saturated Fatty Acid Blood Levels and Cardiometabolic Phenotype in Patients with HFpEF: A Secondary Analysis of the Aldo-DHF Trial.
作者信息
Lechner Katharina, von Schacky Clemens, Scherr Johannes, Lorenz Elke, Bock Matthias, Lechner Benjamin, Haller Bernhard, Krannich Alexander, Halle Martin, Wachter Rolf, Duvinage André, Edelmann Frank
机构信息
Rehabilitation and Sports Medicine, Department of Prevention, School of Medicine, Technical University of Munich, 80992 Munich, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance, 80336 Munich, Germany.
出版信息
Biomedicines. 2022 Sep 15;10(9):2296. doi: 10.3390/biomedicines10092296.
BACKGROUND
Circulating long-chain (LCSFAs) and very long-chain saturated fatty acids (VLSFAs) have been differentially linked to risk of incident heart failure (HF). In patients with heart failure with preserved ejection fraction (HFpEF), associations of blood SFA levels with patient characteristics are unknown.
METHODS
From the Aldo-DHF-RCT, whole blood SFAs were analyzed at baseline in = 404 using the HS-Omega-3-Index methodology. Patient characteristics were 67 ± 8 years, 53% female, NYHA II/III (87%/13%), ejection fraction ≥50%, E/e' 7.1 ± 1.5; and median NT-proBNP 158 ng/L (IQR 82-298). Spearman´s correlation coefficients and linear regression analyses, using sex and age as covariates, were used to describe associations of blood SFAs with metabolic phenotype, functional capacity, cardiac function, and neurohumoral activation at baseline and after 12-month follow-up (12 mFU).
RESULTS
In line with prior data supporting a potential role of de novo lipogenesis-related LCSFAs in the development of HF, we showed that baseline blood levels of C14:0 and C16:0 were associated with cardiovascular risk factors and/or lower exercise capacity in patients with HFpEF at baseline/12 mFU. Contrarily, the three major circulating VLSFAs, lignoceric acid (C24:0), behenic acid (C22:0), and arachidic acid (C20:0), as well as the LCSFA C18:0, were broadly associated with a lower risk phenotype, particularly a lower risk lipid profile. No associations were found between cardiac function and blood SFAs.
CONCLUSIONS
Blood SFAs were differentially linked to biomarkers and anthropometric markers indicative of a higher-/lower-risk cardiometabolic phenotype in HFpEF patients. Blood SFA warrant further investigation as prognostic markers in HFpEF. One Sentence Summary: In patients with HFpEF, individual circulating blood SFAs were differentially associated with cardiometabolic phenotype and aerobic capacity.
背景
循环长链饱和脂肪酸（LCSFAs）和极长链饱和脂肪酸（VLSFAs）与新发心力衰竭（HF）风险的关联存在差异。在射血分数保留的心力衰竭（HFpEF）患者中，血液饱和脂肪酸（SFA）水平与患者特征之间的关联尚不清楚。
方法
在Aldo-DHF-RCT研究中，采用HS-Omega-3-指数方法对404例患者的全血SFA进行了基线分析。患者特征为年龄67±8岁，女性占53%，纽约心脏协会（NYHA）心功能分级II/III级（87%/13%），射血分数≥50%，E/e'为7.1±1.5；NT-proBNP中位数为158 ng/L（四分位间距82-298）。使用性别和年龄作为协变量，通过Spearman相关系数和线性回归分析来描述血液SFA与基线及12个月随访（12 mFU）时的代谢表型、功能能力、心脏功能和神经体液激活之间的关联。
结果
与先前支持从头脂肪生成相关的LCSFAs在HF发生中可能起作用的数据一致，我们发现，在基线/12 mFU时，HFpEF患者的C14:0和C16:0基线血液水平与心血管危险因素和/或较低的运动能力相关。相反，三种主要的循环VLSFAs，二十四烷酸（C24:0）、山嵛酸（C22:0）和花生酸（C20:0），以及LCSFA C18:0，与较低风险表型广泛相关，尤其是较低风险的血脂谱。未发现心脏功能与血液SFA之间存在关联。
结论
在HFpEF患者中，血液SFA与指示较高/较低风险心脏代谢表型的生物标志物和人体测量指标存在差异关联。血液SFA作为HFpEF的预后标志物值得进一步研究。一句话总结：在HFpEF患者中，个体循环血液SFA与心脏代谢表型和有氧运动能力存在差异关联。
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