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Heart failure treatment and serum carnitines in HFpEF and HFrEF with or without hypertension - a pilot study

Hypertension Research volume 48, pages 1109–1114 (2025)Cite this article

A Comment to this article was published on 08 May 2025

Abstract

The ratio of serum acylcarnitines to free carnitines (AC/FC) reflects impaired cardiomyocyte β-oxidization. The effect of heart failure (HF) treatment on AC/FC remained unclear. This pilot study retrospectively examined treatment-induced AC/FC changes in patients with HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) in 148 consecutive inpatients undergoing echocardiography and carnitine measurement at admission and discharge. Symptomatic ACCF/AHA HF stage C/D patients (HFpEF, n = 40; HErEF, n = 24) received standard medical therapy and comprehensive cardiac rehabilitation. At admission, AC/FC levels in HFpEF and HFrEF were significantly higher than in asymptomatic stage A/B (n = 84), decreasing to comparable levels at discharge. AC/FC reduction was associated with improvement of left ventricular ejection fraction through HF treatment in HFpEF, particularly in HFpEF with hypertension, but not in HFrEF. Large-scale, multicenter prospective studies with precise cardiac function assessments are essential to validate the preliminary findings and to clarify the underlying pathophysiological mechanisms.

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Acknowledgements

This work was supported in part by JSPS KAKENHI Grants (HK, 19K08503).

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Authors and Affiliations

  1. Department of Cardiology, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume, Fukuoka, 839-0863, Japan

    Haruhito Harada, Yasuhiro Nishiyama, Atsushi Katoh, Hiroshi Niiyama, Akihiro Iwaki, Yusuke Ohchi, Motoki Sasaki, Yuji Aoki, Norihito Okina & Hisashi Kai

  2. Wada Heart and Kidney Clinic, 1334-8 Harakoga-machi, Tosu, Saga, 841-0071, Japan

    Haruhito Harada

  3. Nishiyama Clinic, 115-4 Waifu, Kikuchi, Kumamoto, 861-1331, Japan

    Yasuhiro Nishiyama

  4. Department of General Medicine, Tanushimaru Central Hospital, 892 Masuoda, Tanushimaru-machi, Kurume, Fukuoka, 839-1213, Japan

    Atsushi Katoh

  5. Department of Cardiology, Yokokura Hospital, 480-2 Nose, Takada-machi, Miyama, Fukuoka, 839-0215, Japan

    Hiroshi Niiyama

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  1. Haruhito Harada
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  2. Yasuhiro Nishiyama
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Correspondence to Haruhito Harada.

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Harada, H., Nishiyama, Y., Katoh, A. et al. Heart failure treatment and serum carnitines in HFpEF and HFrEF with or without hypertension - a pilot study. Hypertens Res 48, 1109–1114 (2025). https://doi.org/10.1038/s41440-025-02106-1

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