Heart failure (HF) is a progressive condition in which the heart muscle is unable to pump blood effectively to meet the body's needs. It affects millions of people globally and imposes a significant burden on healthcare systems due to its high morbidity, mortality, and economic costs. As the prevalence of HF continues to rise, exploring targeted and innovative treatment strategies is becoming increasingly important.
The heart sustains high energy demands and primarily relies on fatty acids as its energy source in the fasting state, with a smaller contribution from glucose. During the progression of HF, there is a shift in cardiac substrate preference toward increased glucose reliance and reduced fatty acid utilization. Initially considered a protective adaptation against oxygen deficiency and lipotoxicity, this metabolic shift led to suggestions that inhibiting fatty acid oxidation could be a therapeutic strategy for HF. However, more recent evidence indicates that enhancing fatty acid utilization through a high-fat diet may attenuate cardiac dysfunction.
Animal studies have demonstrated that increasing fatty acid utilization can reverse myocardial metabolic alterations and improve cardiac function in models of progressive dilated cardiomyopathy (DCM) with reduced ejection fraction. In one study, the administration of a high-fat diet restored normal myocardial metabolism, resulting in disease regression. Similarly, research using large animal models has shown that high-fat diets can significantly improve left ventricular ejection fraction (LVEF), further supporting the potential benefits of this approach.
In human studies, preliminary findings suggest that lipid-based interventions may acutely improve cardiac function in individuals with HF and reduced LVEF. However, evidence on the long-term efficacy and safety of high-fat dietary patterns in HF management remains limited.
This study aims to compare the effects of a high-fat diet versus a standard diet with a conventional macronutrient composition on non-ischemic DCM with reduced LVEF. The primary objective is to evaluate and compare the impact of a high-fat diet versus a standard diet on LVEF. Secondary objectives include assessing the effects on left ventricular strain, diastolic function, and blood parameters, as well as evaluating the feasibility and degree of adherence to each dietary intervention.
