Dietary therapy in heart failure with preserved ejection fraction and/or left ventricular diastolic dysfunction in...

Area of Science:

• Cardiology
• Metabolic Syndrome Research
• Nutritional Science

Background:

• Heart failure, particularly heart failure with preserved ejection fraction (HFpEF), is a growing epidemic linked to risk factors like obesity and type-2 diabetes.
• HFpEF shares a similar prognosis to systolic heart failure but lacks effective treatments.
• Diastolic dysfunction in HFpEF is often associated with insulin resistance, suggesting a connection to metabolic syndrome.

Purpose of the Study:

• To present a diagnostic approach for diastolic dysfunction that accounts for age-related changes and identifies metabolic risk factors.
• To explore therapeutic strategies targeting insulin sensitivity and metabolic health for HFpEF.
• To discuss the role of dietary macronutrient composition in managing metabolic syndrome and its cardiac manifestations.

Main Methods:

• Biomathematical correction to diagnose diastolic dysfunction and identify age-independent metabolic risk factors.
• Evaluation of therapeutic interventions including dietary energy restriction, carbohydrate modification, and aerobic exercise.
• Review of recent publications and meta-analyses on dietary therapy for metabolic syndrome.

Main Results:

• Insulin resistance frequently causes reduced cardiac energy reserve in HFpEF patients.
• Therapies aimed at normalizing insulin sensitivity, such as carbohydrate modification and exercise, are beneficial.
• Dietary interventions focusing on macronutrient composition can improve metabolic syndrome manifestations.

Conclusions:

• Modulating carbohydrate intake normalizes glucose and insulin levels after meals.
• Reduced carbohydrate intake improves all aspects of metabolic syndrome and lowers cardiovascular risk.
• HFpEF can be viewed as a cardiac manifestation of metabolic syndrome, treatable through metabolic interventions.