| Suppression of circulating free fatty acids with acipimox in chronic heart failure patients changes whole body metabolism but does not affect cardiac function. | |
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MedLine Citation:
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PMID: 20709866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Circulating free fatty acids (FFAs) may worsen heart failure (HF) due to myocardial lipotoxicity and impaired energy generation. We studied cardiac and whole body effects of 28 days of suppression of circulating FFAs with acipimox in patients with chronic HF. In a randomized double-blind crossover design, 24 HF patients with ischemic heart disease [left ventricular ejection fraction: 26 ± 2%; New York Heart Association classes II (n = 13) and III (n = 5)] received 28 days of acipimox treatment (250 mg, 4 times/day) and placebo. Left ventricular ejection fraction, diastolic function, tissue-Doppler regional myocardial function, exercise capacity, noninvasive cardiac index, NH(2)-terminal pro-brain natriuretic peptide (NT-pro-BNP), and whole body metabolic parameters were measured. Eighteen patients were included for analysis. FFAs were reduced by 27% in the acipimox-treated group [acipimox vs. placebo (day 28-day 0): -0.10 ± 0.03 vs. +0.01 ± 0.03 mmol/l, P < 0.01]. Glucose and insulin levels did not change. Acipimox tended to increase glucose and decrease lipid utilization rates at the whole body level and significantly changed the effect of insulin on substrate utilization. The hyperinsulinemic euglycemic clamp M value did not differ. Global and regional myocardial function did not differ. Exercise capacity, cardiac index, systemic vascular resistance, and NT-pro-BNP were not affected by treatment. In conclusion, acipimox caused minor changes in whole body metabolism and decreased the FFA supply, but a long-term reduction in circulating FFAs with acipimox did not change systolic or diastolic cardiac function or exercise capacity in patients with HF. |
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Authors:
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Mads Halbirk; Helene Nørrelund; Niels Møller; Ole Schmitz; Liv Gøtzsche; Roni Nielsen; Jens Erik Nielsen-Kudsk; Søren Steen Nielsen; Torsten Toftegaard Nielsen; Hans Eiskjær; Hans Erik Bøtker; Henrik Wiggers |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-08-13 |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 299 ISSN: 1522-1539 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: 2010-11-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H1220-5 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. MSHL@ki.au.dk |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Glucose / metabolism Chronic Disease Cross-Over Studies Double-Blind Method Exercise Tolerance / drug effects, physiology Fatty Acids, Nonesterified / blood* Female Heart / drug effects*, physiology Heart Failure / blood*, drug therapy, physiopathology Humans Hypolipidemic Agents / pharmacology*, therapeutic use Male Metabolism / drug effects*, physiology Middle Aged Pyrazines / pharmacology*, therapeutic use Stroke Volume / drug effects, physiology Vascular Resistance / drug effects, physiology |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Fatty Acids, Nonesterified; 0/Hypolipidemic Agents; 0/Pyrazines; 51037-30-0/acipimox |
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