title: Effects of short-term manipulation of serum FFA concentrations on left ventricular energy metabolism and function in patients with heart failure: no association with circulating bio-markers of inflammation.
abstract: OBJECTIVE
  We wanted to assess the effects of short-term changes in serum free fatty acids (FFAs) on left ventricular (LV) energy metabolism and function in patients with heart failure and whether they correlated with circulating markers of inflammation.
  
  
  RESULTS
  LV function and phosphocreatine (PCr)/ATP ratio were assessed using MR imaging (MRI) and 31P magnetic resonance spectroscopy (MRS) in 11 men with chronic heart failure in two experimental conditions 7 days apart. Study 1: MRI and 31P-MRS were performed before and 3-4 h after i.v. bolus + continuous heparin infusion titrated to achieve a serum FFA concentration of 1.20 mM. Study 2: The same protocol was performed before and after the oral administration of acipimox titrated to achieve a serum FFA concentration of 0.20 mM. Serum concentrations of IL6, TNF-α, PAI-1, resistin, visfatin and leptin were simultaneously assessed. Serum glucose and insulin concentrations were not different between studies. The PCr/ATP ratio (percent change from baseline: +6.0 ± 16.9 and -16.6 ± 16.1 % in Study 1 and Study 2, respectively; p = 0.005) and the LV ejection fraction (-1.5 ± 4.0 and -6.9 ± 6.3 % in Study 1 and Study 2, respectively; p = 0.044) were reduced during low FFA when compared to high FFA. Serum resistin was higher during Study 1 than in Study 2 (p < 0.05 repeated measures ANOVA); meanwhile, the other adipocytokines were not different.
  
  
  CONCLUSIONS
  FFA deprivation, but not excess, impaired LV energy metabolism and function within hours. Cautions should be used when sudden iatrogenic modulation of energy substrates may take place in vulnerable patients.
authors.affiliation: Clinical Cardiology - Heart Failure Clinic, Ospedale San Raffaele, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Salerno
authors.forename: G
authors.initials: G
authors.lastname: Fragasso
authors.forename: A
authors.initials: A
authors.lastname: Esposito
authors.forename: T
authors.initials: T
authors.lastname: Canu
authors.forename: G
authors.initials: G
authors.lastname: Lattuada
authors.forename: G
authors.initials: G
authors.lastname: Manzoni
authors.forename: A
authors.initials: A
authors.lastname: Del Maschio
authors.forename: A
authors.initials: A
authors.lastname: Margonato
authors.forename: F
authors.initials: F
authors.lastname: De Cobelli
authors.forename: G
authors.initials: G
authors.lastname: Perseghin
mesh_terms: D054392:Adipokines / Q000097:blood; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004734:Energy Metabolism; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D007249:Inflammation / Q000097:blood* / Q000000981:diagnostic imaging; D007328:Insulin / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000008:administration & dosage; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D016277:Ventricular Function, Left
chemical_list: D054392:Adipokines; D015415:Biomarkers; D005230:Fatty Acids, Nonesterified; D000960:Hypolipidemic Agents; D007328:Insulin; D011719:Pyrazines; D014409:Tumor Necrosis Factor-alpha; C027696:acipimox