Reducing Cardiac Steatosis: Interventions to Improve Diastolic Function: A Narrative Review

Area of Science:

• Cardiology
• Metabolic Disease

Background:

• Heart failure is a leading cause of global morbidity and mortality.
• Diastolic dysfunction is the primary driver of heart failure with preserved ejection fraction.
• Cardiac adipose tissue deposition is implicated in the pathogenesis of diastolic dysfunction.

Purpose of the Study:

• To review interventions targeting cardiac adipose tissue to mitigate diastolic dysfunction.
• To explore the impact of lifestyle modifications, medications, and surgical procedures on cardiac fat and diastolic function.

Main Methods:

• Literature review of studies investigating interventions for diastolic dysfunction.
• Analysis of the effects of dietary changes, exercise, pharmacological agents, and bariatric surgery on cardiac steatosis.

Main Results:

• A healthy diet low in fat reduces visceral adiposity and improves diastolic function.
• Aerobic and resistance exercises decrease visceral and epicardial fat, ameliorating diastolic dysfunction.
• Various medications (e.g., metformin, GLP-1 analogues, SGLT-2 inhibitors) and bariatric surgery show potential in improving cardiac steatosis and diastolic function.

Conclusions:

• Reducing cardiac adipose tissue is a viable strategy for managing diastolic dysfunction.
• Lifestyle interventions, pharmacotherapy, and bariatric surgery offer promising avenues for improving diastolic function in heart failure with preserved ejection fraction.