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Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients

Background: Perturbation of energy metabolism exacerbates cardiac dysfunction, serving as a potential therapeutic target in congestive heart failure. Although circulating free fatty acids (FFAs) are linked to insulin resistance and risk of coronary heart disease, it still remains unclear whether cir...

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Autores principales: Yu, Yi, Jin, Chunna, Zhao, Chengchen, Zhu, Shiyu, Meng, Simin, Ma, Hong, Wang, Jian'an, Xiang, Meixiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727366/
https://www.ncbi.nlm.nih.gov/pubmed/35004879
http://dx.doi.org/10.3389/fcvm.2021.761537
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author Yu, Yi
Jin, Chunna
Zhao, Chengchen
Zhu, Shiyu
Meng, Simin
Ma, Hong
Wang, Jian'an
Xiang, Meixiang
author_facet Yu, Yi
Jin, Chunna
Zhao, Chengchen
Zhu, Shiyu
Meng, Simin
Ma, Hong
Wang, Jian'an
Xiang, Meixiang
author_sort Yu, Yi
collection PubMed
description Background: Perturbation of energy metabolism exacerbates cardiac dysfunction, serving as a potential therapeutic target in congestive heart failure. Although circulating free fatty acids (FFAs) are linked to insulin resistance and risk of coronary heart disease, it still remains unclear whether circulating FFAs are associated with the prognosis of patients with acute heart failure (AHF). Methods: This single-center, observational cohort study enrolled 183 AHF patients (de novo heart failure or decompensated chronic heart failure) in the Second Affiliated Hospital, Zhejiang University School of Medicine. All-cause mortality and heart failure (HF) rehospitalization within 1 year after discharge were investigated. Serum FFAs were modeled as quartiles as well as a continuous variable (per SD of FFAs). The restricted cubic splines and cox proportional hazards models were applied to evaluate the association between the serum FFAs level and all-cause mortality or HF rehospitalization. Results: During a 1-year follow-up, a total of 71 (38.8%) patients had all-cause mortality or HF rehospitalization. The levels of serum FFAs positively contributed to the risk of death or HF rehospitalization, which was not associated with the status of insulin resistance. When modeled with restricted cubic splines, the serum FFAs increased linearly for the incidence of death or HF rehospitalization. In a multivariable analysis adjusting for sex, age, body-mass index, coronary artery disease, diabetes mellitus, hypertension, left ventricular ejection fraction and N-terminal pro-brain natriuretic peptid, each SD (303.07 μmol/L) higher FFAs were associated with 26% higher risk of death or HF rehospitalization (95% confidence interval, 2–55%). Each increasing quartile of FFAs was associated with differentially elevated hazard ratios for death or HF rehospitalization of 1 (reference), 1.71 (95% confidence interval, [0.81, 3.62]), 1.41 (95% confidence interval, [0.64, 3.09]), and 3.18 (95% confidence interval, [1.53, 6.63]), respectively. Conclusion: Serum FFA levels at admission among patients with AHF were associated with an increased risk of adverse outcomes. Additional studies are needed to determine the causal-effect relationship between FFAs and acute cardiac dysfunction and whether FFAs could be a potential target for AHF management.
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spelling pubmed-87273662022-01-06 Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients Yu, Yi Jin, Chunna Zhao, Chengchen Zhu, Shiyu Meng, Simin Ma, Hong Wang, Jian'an Xiang, Meixiang Front Cardiovasc Med Cardiovascular Medicine Background: Perturbation of energy metabolism exacerbates cardiac dysfunction, serving as a potential therapeutic target in congestive heart failure. Although circulating free fatty acids (FFAs) are linked to insulin resistance and risk of coronary heart disease, it still remains unclear whether circulating FFAs are associated with the prognosis of patients with acute heart failure (AHF). Methods: This single-center, observational cohort study enrolled 183 AHF patients (de novo heart failure or decompensated chronic heart failure) in the Second Affiliated Hospital, Zhejiang University School of Medicine. All-cause mortality and heart failure (HF) rehospitalization within 1 year after discharge were investigated. Serum FFAs were modeled as quartiles as well as a continuous variable (per SD of FFAs). The restricted cubic splines and cox proportional hazards models were applied to evaluate the association between the serum FFAs level and all-cause mortality or HF rehospitalization. Results: During a 1-year follow-up, a total of 71 (38.8%) patients had all-cause mortality or HF rehospitalization. The levels of serum FFAs positively contributed to the risk of death or HF rehospitalization, which was not associated with the status of insulin resistance. When modeled with restricted cubic splines, the serum FFAs increased linearly for the incidence of death or HF rehospitalization. In a multivariable analysis adjusting for sex, age, body-mass index, coronary artery disease, diabetes mellitus, hypertension, left ventricular ejection fraction and N-terminal pro-brain natriuretic peptid, each SD (303.07 μmol/L) higher FFAs were associated with 26% higher risk of death or HF rehospitalization (95% confidence interval, 2–55%). Each increasing quartile of FFAs was associated with differentially elevated hazard ratios for death or HF rehospitalization of 1 (reference), 1.71 (95% confidence interval, [0.81, 3.62]), 1.41 (95% confidence interval, [0.64, 3.09]), and 3.18 (95% confidence interval, [1.53, 6.63]), respectively. Conclusion: Serum FFA levels at admission among patients with AHF were associated with an increased risk of adverse outcomes. Additional studies are needed to determine the causal-effect relationship between FFAs and acute cardiac dysfunction and whether FFAs could be a potential target for AHF management. Frontiers Media S.A. 2021-12-22 /pmc/articles/PMC8727366/ /pubmed/35004879 http://dx.doi.org/10.3389/fcvm.2021.761537 Text en Copyright © 2021 Yu, Jin, Zhao, Zhu, Meng, Ma, Wang and Xiang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Yu, Yi
Jin, Chunna
Zhao, Chengchen
Zhu, Shiyu
Meng, Simin
Ma, Hong
Wang, Jian'an
Xiang, Meixiang
Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title_full Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title_fullStr Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title_full_unstemmed Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title_short Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients
title_sort serum free fatty acids independently predict adverse outcomes in acute heart failure patients
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727366/
https://www.ncbi.nlm.nih.gov/pubmed/35004879
http://dx.doi.org/10.3389/fcvm.2021.761537
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