Effects of amino acid supplementation on left ventricular remodeling in patients with chronic heart failure with decreased systolic function and diabetes mellitus: rationale and design of a magnetic resonance imaging study.
A considerable number of patients with reduced systolic function caused by primary or ischemic cardiomyopathy have viable and noncontractile myocardium. This may be related to numerous and perhaps overlapping factors, such as chronic ischemia (stunning/hibernation), neurohormonal abnormalities, oxidative stress, metabolic imbalances, and/or nutritional depletion. Changes in myocardial substrate utilization have adverse effects on the metabolism of the viable but noncontractile myocardium. Shifting the energy substrate preference away from fatty acids and replenishing the tricarboxylic acid cycle components via amino acids rather than via fatty acids would increase adenosine triphosphate production, with positive effects on cellular metabolism. A proposed study design is described and will be piloted through the Effects of Diatrofen on Myocardial Function in Patients with Chronic Heart Failure trial (D-CHF), an evaluation of an oral amino acid supplementation treatment in outpatients with heart failure.
Klein
Liviu
L
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Gattis
Wendy A
WA
Borrello
Francesco
F
Wu
Edwin
E
O'Connor
Christopher M
CM
Gheorghiade
Mihai
M
D000284:Administration, Oral; D000601:Amino Acids, Essential / Q000008:administration & dosage*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000178:diet therapy* / Q000473:pathology; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D006333:Heart Failure / Q000150:complications / Q000178:diet therapy* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D020257:Ventricular Remodeling
D000601:Amino Acids, Essential; D004044:Dietary Proteins