Dietary fat and heart failure: moving from lipotoxicity to lipoprotection

Circ Res. 2012 Mar 2;110(5):764-76. doi: 10.1161/CIRCRESAHA.111.253104.

Abstract

There is growing evidence suggesting that dietary fat intake affects the development and progression of heart failure. Studies in rodents show that in the absence of obesity, replacing refined carbohydrate with fat can attenuate or prevent ventricular expansion and contractile dysfunction in response to hypertension, infarction, or genetic cardiomyopathy. Relatively low intake of n-3 polyunsaturated fatty acids from marine sources alters cardiac membrane phospholipid fatty acid composition, decreases the onset of new heart failure, and slows the progression of established heart failure. This effect is associated with decreased inflammation and improved resistance to mitochondrial permeability transition. High intake of saturated, monounsaturated, or n-6 polyunsaturated fatty acids has also shown beneficial effects in rodent studies. The underlying mechanisms are complex, and a more thorough understanding is needed of the effects on cardiac phospholipids, lipid metabolites, and metabolic flux in the normal and failing heart. In summary, manipulation of dietary fat intake shows promise in the prevention and treatment of heart failure. Clinical studies generally support high intake of n-3 polyunsaturated fatty acids from marine sources to prevent and treat heart failure. Additional clinical and animals studies are needed to determine the optimal diet in terms of saturated, monounsaturated, and n-6 polyunsaturated fatty acids intake for this vulnerable patient population.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Dietary Fats / therapeutic use*
  • Disease Models, Animal
  • Disease Progression*
  • Fatty Acids, Omega-3 / therapeutic use
  • Fatty Acids, Omega-6 / therapeutic use
  • Heart Failure / physiopathology
  • Heart Failure / prevention & control*
  • Lipid Metabolism / physiology
  • Lipids / therapeutic use*
  • Mice
  • Rats

Substances

  • Dietary Fats
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Lipids