Heart Failure, Nutrition, Healthy
Conditions
Keywords
MCT, Glucose homeostase, ketogenese
Brief summary
The effect of an acute intake of medium-chain fatty acids on heart function measured by cardiac magnetic resonance imaging (CMR) will be measured in individuals with heart failure with reduced ejection fraction (HFrEF) and in matched healthy controls with normal heart function. This aim will be investigated in a cross-over study including two visits: acute intake of medium-chain fatty acid or long-chain fatty acid as control. In addition, the effect of acute medium-chain fatty acid compared with long-chain fatty acid intake on whole-body lipid and glucose metabolism will be investigated.. The hypothesis is that acute consumption of medium-chain fatty acid will improve cardiac function in patients with heart failure.
Detailed description
The study will be conducted as a block-randomized cross-over study in participants with heart failure (HFrEF) (n=10) and in healthy age- and BMI-matched participants with normal heart function (n=13) as control group. The participants will undergo two experimental days separated by a two to four weeks wash-out period. At the test days, participants will consume cocoa milk added 0.5g/kg body weight of medium-chain fatty acid oil or long-chain fatty acid oil as control. Two days prior to metabolic testing, participants will consume a controlled diet. The controlled diet will be handed out to the participant. Initially, potential participants are invited to an information meeting and after informed consent a screening is performed. Following inclusion, one of two identical test days are conducted consuming either medium-chain fatty acids or long-chain fatty acids in a randomized order. The participants will arrive after a 4 h period with no intake of food and drinks except water, and by passive transport (train, bus or car). After 30 min of rest in the supine position, venflon catheters are inserted into the right and left antecubital vein. After insertion of the catheters, fasting venous blood samples are drawn (20 ml in total) from one of the catheters for analysis of ketones, glucose, insulin, C-peptide, fatty acids, triacylglycerol, lipidomics and concentration of hepatokines. ECG monitoring is initiated. Thereafter, the first basal CMR will be performed. After the basal blood sampling and scanning, the participants consume the cocoa-drink with 60g medium-chain fatty acid or 60g long-chain fatty acid and remains resting for the following 4 hours. Venous blood samples (15 ml) are obtained at 0, 30, 60, 80 and 135 min In total, up to 110 ml blood is obtained during the test day. At 90 min, the CMR will be repeated. At the end of the test day, the participant is served a meal. The duration of the test day is 4 hours. After a wash-out period of 2-4 weeks the test day will be repeated with consumption of the other fatty acid type.
Interventions
DIETARY_SUPPLEMENTacute intake of medium-chain fatty acids or long-chain fatty acids in patients
The intake of an oil comprising of either medium -chain fatty acids or long-chail fatty acids
DIETARY_SUPPLEMENTAcute intake of medium-chain fatty acids or long-chain fatty acids in healthy individuals
Acute intake of MCT and LCT in healthy individuals in a cross-over design
Sponsors
University of Copenhagen
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
A parallel, cross-over study in participants with heart failure and in a healthy age- and BMI-matched participants with normal heart function as control group.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
for patients: * Heart failure with reduced ejection fraction; I. Left ventricular ejection fraction ≤45% and optimal, stable HFrEF treatment according to guidelines II. Functional classification New York Heart Association class II-III. * No uncorrected cardiac valvular disease * No signs or symptoms of myocardial infarction within the previous 3 months * No permanent of persistent arterial fibrillation. For controls: • No use of medications with influence on heart function
Exclusion criteria
For all participants: * Diabetes, kidney or liver disease. * Contraindications to CMR, e.g., abdominal height exceed limitations of the MR- scanner, pacemaker, stent, neurostimulator, or other electronic device implanted, implanted metal devices, severe claustrophobia, or physiological diseases * Pregnant, lactating or planning to become pregnant within the study period * To ensure safety, no gadobutrol contrast can be administrered to participants with severe reduced kidney function, indicated by glomerular filtration rate (eGFR) \< 30 ml/min/1.73m2, accessed from the obtained screening blood sample or from the Patient Record. In such cases, potential participants will be excluded from the study. * Blood donation during and \< 3 month prior to study * Simultaneous participation in other clinical trials * Inability, physically or mentally, to comply with the procedure required by the study protocol ad evaluated by the primary investigator, study manager or clinical responsible
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Heart function | 0-5 weeks | To investigate the effect of acute medium-chain fatty acids intake on heart function assessed by cardiac output (l/min) measured by cardiac magnetic resonance imaging (CMR) in individuals with heart failure with reduced ejection fraction (HFrEF) and in matched healthy controls with normal heart function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Measure of Ketones | 0-5 weeks | Measure the effects of acute medium-chain fatty acid intake on plasma ketone concentration ( in mmol/l) as compared with long-chain fatty acid intake in individuals with and without heart failure. |
| Plasma Glucose | 0-5 weeks | measure of plasma glucose concentration (in mmol/l) after the intake of medium-chain fatty acids as compared with the intake of long-chain fatty acids in individuals with and without heart failure |
| Measure of plasma lipids | 0-5 weeks | measure of plasma triacylglycerol content in mmol/l after the intake of medium-chain fatty acids as compared with the intake of long-chain fatty acids in individuals with and without heart failure. |
Countries
Denmark
Outcome results
None listed