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Increased acylcarnitines in infant heart failure indicate fatty acid oxidation inhibition: towards therapeutic

Jean Issa1,2, Pierre Lodewyckx1,2, Hélène Blasco2,3

  • 1Institut des Cardiopathies Congénitales de Tours, Hôpital Gatien de Clocheville, CHU Tours, 49 Boulevard Béranger, Tours, 37000, France.

ESC Heart Failure
|August 24, 2023
PubMed

Insights

Children with heart failure show altered fatty acid metabolism, with increased acylcarnitines indicating reduced fat burning. This metabolic shift may worsen cardiac function and suggests potential for metabolic therapies in pediatric heart failure.

Area of Science:

  • Biochemistry
  • Pediatric Cardiology
  • Metabolomics

Background:

  • Heart failure in adults involves a shift from fatty acid to carbohydrate metabolism.
  • This metabolic adaptation in adults becomes maladaptive, decreasing energy conversion and increasing toxic lipid byproducts.
  • Metabolic changes in pediatric heart failure remain largely uncharacterized.

Purpose of the Study:

  • To investigate fatty acid oxidation in children with heart failure.
  • To compare acylcarnitine profiles in children with dilated cardiomyopathy and heart failure (DCM-HF) to healthy controls.

Main Methods:

  • Acylcarnitine profiles were analyzed from dried blood spots of children under 16 years.
  • Nine children with DCM-HF and eight control children were included.
  • Statistical analysis compared acylcarnitine levels and ratios between groups.

Main Results:

  • Total acylcarnitines were significantly elevated (3.1-fold) in DCM-HF children compared to controls.
  • Increases were observed across short-chain (1.9-fold), medium-chain (2.6-fold), and long-chain (2.0-fold) acylcarnitines.
  • Elevated C16OH/C16 and C18OH/C18 ratios suggested reduced hydroxyl acyl-CoA dehydrogenase activity.

Conclusions:

  • Pediatric heart failure is associated with down-regulated fatty acid oxidation.
  • These lipidomic alterations may contribute to impaired cardiac function.
  • Metabolic interventions could be a potential therapeutic strategy for pediatric heart failure.
Abstract

Keywords:
AcylcarnitinesChildrenDilated cardiomyopathyFatty acid beta-oxidationHeart failure

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