ArticleCirculation2023
Myocardial Metabolomics of Human Heart Failure With Preserved Ejection Fraction.
Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 184 papers, 2 of them syntheses that pooled it.
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Who cites it
184 citing papers in PubMed, 2 syntheses or guidelines pooled it, 262 citations in OpenAlex.
- Cardiac energy substrate utilization in heart failure with preserved ejection fraction: reconciling conflicting evidence on fatty acid and glucose metabolism.American journal of physiology. Heart and circulatory physiology · 2025Pooled it
- Effects of trimetazidine on heart failure with reduced ejection fraction and associated clinical outcomes: a systematic review and meta-analysis.Open heart · 2024Pooled it
- Effects of metabolic syndrome on cardiovascular outcomes in non-obese heart failure patients.ESC heart failure · 2026Trial
- Targeted Metabolomic Profiling of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The PRESERVED-HF Trial.JACC. Heart failure · 2024Trial
- Trimetazidine in heart failure with preserved ejection fraction: a randomized controlled cross-over trial.ESC heart failure · 2023Trial
- Trial
- Altered Acylcarnitine Metabolism in cardiac diseases: From molecular mechanisms to translational potential.International journal of cardiology. Heart & vasculature · 2026Review
- BMAL1 in cardiovascular diseases: Molecular mechanisms, circadian regulation and translational perspectives (Review).Molecular medicine reports · 2026Review
- Diagnostic classification and medical decision of idiopathic asthenozoospermia based on metabolomics analysis of seminal plasma.Journal of endocrinological investigation · 2026Article
- A metabolic-epigenetic switch governs multicellular cardiac repair following succinate dehydrogenase inhibition.Nature cardiovascular research · 2026Article
- Roles of inflammation and metabolic dysfunction in cardiovascular diseases: molecular mechanisms and therapeutic targets.Molecular biomedicine · 2026Review
- Review
- Reversing the pipeline: a 'human-first' multi-omics approach to cardiovascular discovery.Experimental & molecular medicine · 2026Review
- Multi-omics analysis of early reperfused ischemic heart reveals ERRβ/γ activation protects against acute myocardial infarction injury.Journal of advanced research · 2026Article
- Amino Acid Metabolism in Health and Disease.MedComm · 2026Review
- Maternal exercise is associated with enhanced systolic reserve and altered mitochondrial respiration in adult female offspring.American journal of physiology. Heart and circulatory physiology · 2026Article
- Beyond eGFR and Albuminuria: Biological Pathways and Multiomics in Cardiovascular-Kidney-Metabolic Disease.Kidney international reports · 2026Review
- Circulating Organic Acid Profiles in Non-Ischaemic Cardiomyopathy: A Case-Control Study.Journal of cardiovascular development and disease · 2026Article
- Sarcopenia and Its Associated Metabolic Profile Predict Incident Heart Failure: A Prospective Cohort Study of 267 335 Adults in the UK Biobank.Journal of the American Heart Association · 2026Article
- Integrated Myocardial and Plasma Lipidome Across the Human Obesity-Heart Failure Spectrum.Research square · 2026Article
124 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe human heart primarily metabolizes fatty acids, and this decreases as alternative fuel use rises in heart failure with reduced ejection fraction (HFrEF). Patients with severe obesity and diabetes are thought to have increased myocardial fatty acid metabolism, but whether this is found in those who also have heart failure with preserved ejection fraction (HFpEF) is unknown.
methodsPlasma and endomyocardial biopsies were obtained from HFpEF (n=38), HFrEF (n=30), and nonfailing donor controls (n=20). Quantitative targeted metabolomics measured organic acids, amino acids, and acylcarnitines in myocardium (72 metabolites) and plasma (69 metabolites). The results were integrated with reported RNA sequencing data. Metabolomics were analyzed using agnostic clustering tools, Kruskal-Wallis test with Dunn test, and machine learning.
resultsAgnostic clustering of myocardial but not plasma metabolites separated disease groups. Despite more obesity and diabetes in HFpEF versus HFrEF (body mass index, 39.8 kg/m
conclusionsDespite marked obesity and diabetes, HFpEF myocardium exhibited lower fatty acid metabolites compared with HFrEF. Ketones and metabolites of the tricarboxylic acid cycle and BCAA were also lower in HFpEF, suggesting insufficient use of alternative fuels. These differences were not detectable in plasma and challenge conventional views of myocardial fuel use in HFpEF with marked diabetes and obesity and suggest substantial fuel inflexibility in this syndrome.
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