Acute effects of oral triglyceride load on dynamic changes in peripheral endothelial function in heart failure patients with reduced ejection fraction and healthy controls

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 30; no. 11; pp. 1961 - 1966
• Main Authors: Shafieesabet, Azadeh, Scherbakov, Nadja, Ebner, Nicole, Sandek, Anja, Lokau, Stefanie, von Haehling, Stephan, Anker, Stefan D., Lainscak, Mitja, Laufs, Ulrich, Doehner, Wolfram
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 30.10.2020
• Subjects: acute effects; Administration, Oral; Adult; Aged; blood flow; Case-Control Studies; cream; Cross-Sectional Studies; Endothelial function; Endothelium, Vascular - physiopathology; fasting; Female; flow; Heart failure; Heart Failure - diagnosis; Heart Failure - physiopathology; Humans; hyperemia; Hyperemia - physiopathology; hypertriglyceridemia; Hypertriglyceridemia - physiopathology; Male; metabolism; Middle Aged; nutrition; Oral triglyceride load; patients; Postprandial Period; Prospective Studies; Reactive hyperemia index; Stroke Volume; technology; Time Factors; triacylglycerols; Triglycerides - administration & dosage; Ventricular Function, Left; Heart failure; Endothelial function; Reactive hyperemia index; Oral triglyceride load
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2020.05.018

Postprandial hyperlipaemia impairs endothelial function, possibly via oxidative-stress-mediated mechanisms. The aim of this study was to evaluate the acute effects of an oral triglyceride load (OTGL) on peripheral endothelial function in heart failure patients with reduced ejection fraction (HFrEF) compared to healthy controls. Prospective cross-sectional. We enrolled 47 patients with HFrEF and 20 healthy controls. Peripheral endothelial function was assessed with EndoPAT2000 technology using a reactive hyperaemia index (RHI) and pulse wave amplitude (PWA) at baseline (after 8-h overnight fasting) as well as 1, 2, 3 and 4-h post-OTGL consumption (250-ml cream drink). Pulse wave amplitude index (PWAI) was calculated as a ratio of PWA at each time point to the baseline PWA. RHI at baseline was lower in HFrEF patients compared to controls (1.7 ± 0.3 and 2.3 ± 0.6, respectively; P = 0.001). The OTGL accounted for a physiologic increase in PWA in healthy controls (p = 0.01), but this change was not observed in HFrEF patients. After 4 h, vasodilator response was significantly increased in healthy controls but not patients with HFrEF (2.3 ± 1.3 vs. 1.3 ± 0.8 respectively, P < 0.05). The main finding of this study was the impaired postprandial dynamic changes in peripheral endothelial function in patients with HFrEF compared to healthy controls. A high-fat load that caused acute hypertriglyceridaemia significantly increased resting blood flow and peak flow at reactive hyperaemia in healthy subjects. By contrast, patients with HFrEF exhibited impaired dynamic changes in peripheral endothelial function after oral triglyceride load. •Impaired postprandial dynamic changes of peripheral endothelial function in patients with heart failure compared to healthy controls.•A high-fat load that causes an acute hypertriglyceridemia led to a significant increase of resting blood flow and peak flow at reactive hyperemia in healthy subjects.•An oral triglyceride load induced only a minor non-significant effect on the blood flow in heart failure patients.