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Fat Buildup Found in Hearts of Obese or Diabetic Heart Failure Patients
Fat Buildup Found in Hearts of Obese or Diabetic Heart Failure Patients -- Posted by Gumbo on 12-05-04 06:58
Fat Buildup Found in Hearts of Obese or Diabetic Heart Failure Patients
Diabetic or obese patients suffering advanced heart failure have higher
levels of fat embedded in their hearts and greater molecular evidence of
haywire cardiac metabolism, a research team led by cardiologists at the
University of Texas Medical School at Houston reports.
Heart failure is associated with both obesity and diabetes, but the
mechanisms by which damage occurs are not well understood, said senior
author Heinrich Taegtmeyer, MD, PhD, professor of cardiology.
"In cardiology, we've long been concerned about fat accumulating in the
artery walls and blocking the flow of blood to the heart. What we are
finding now is that the buildup of fat doesn't stop in the blood vessels,
it's actually worse in heart muscle cells," Taegtmeyer said. "We also report
in this paper that diabetes and obesity appear to cause metabolic
irregularities in the heart tissue."
Gene expression and protein findings in the paper provide potential
long-term targets for treating heart failure, which afflicts 5 million U.S.
patients annually.
Researchers examined 27 failing hearts that were removed during transplants
and compared them to 8 donor hearts that were not failing but were otherwise
unsuitable for transplant.
Eight of the failing hearts (30%) showed high levels of triglycerides - a
fat storage and transport molecule. Levels of triglycerides in failing
hearts were four times the level in obese or diabetic patients as they were
in non failing hearts. The findings were published in the November 2004
issue of FASEB Journal.
The research team associated this buildup of triglycerides in the heart
muscle, called lipotoxicity, with dysfunctional expression of genes related
to the heart's metabolism of fatty acids, its contractile function, and an
inflammatory protein known to contribute to insulin resistance.
The human results track with a rat model of the lipotoxic heart, which has
been shown to cause improper cardiac contraction in the rodents, said first
author Saumya Sharma, MD, a cardiology fellow and researcher in Taegtmeyer's
lab.
A normal heart derives two-thirds of its energy requirement by metabolizing
fatty acids, which are carried in triglycerides, Sharma said. Lipotoxic
hearts store some triglycerides in the muscle tissue rather than
metabolizing them.
In obese people, Taegtmeyer and his team theorized that this occurs because
the person's fat cells, which capture and store excess triglycerides, fill
up. Because people have a set number of fat cells, once they are full,
excess fat lodges in muscle tissue, where it wreaks molecular havoc.
"The heart is a muscle, too, and it's not spared from this onslaught of
fat," Taegtmeyer explained. "The heart is designed to contract, but if
lipids displace its contractile proteins, that results in impaired heart
function."
Taegtmeyer and colleagues are testing this hypothesis among obese patients
who have elected to have bariatric surgery (surgical reduction of stomach
size). Patients in the study volunteer to have their cardiac function
analyzed and to provide a small sample of thigh muscle tissue before and
after their surgery. Taegtmeyer's team will then assess whether weight loss
after surgery results in improved heart function and decreased levels of
lipids in muscle tissue.
Earlier research by Taegtmeyer showed that diabetes causes toxic levels of
lipids and glucose to build up in the heart. This article was prepared by
Biotech Week editors from staff and other reports. Copyright 2004, Biotech
Week via NewsRx.com & NewsRx.net.
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