High-fat ketogenic diet could prevent, reverse heart failure, study finds

High fat or ketogenic diets could prevent or reverse heart failure caused by a metabolic process, according to a new study from Saint Louis University published in the journal Nature Metabolism.

For the study, researchers looked at a metabolic process that seems to be turned down in failing human hearts. In an animal model, drastic heart failure in mice was bypassed by switching to high fat or ketogenic diets, according to the study.

The heart's myocardium requires vast amounts of chemical energy stored in nutrients to fuel cardiac contraction, the researchers said. To maintain this high metabolic capacity, the heart is flexible and can adapt to altered metabolic fuel supplies during diverse developmental, nutritional, or physiologic conditions. Impaired flexibility, however, is associated with cardiac dysfunction in conditions including diabetes and heart failure.

The mitochondrial pyruvate carrier (MPC) complex, composed of MPC1 and MPC2, is required for pyruvate import into the mitochondria. This study demonstrates that MPC expression is decreased in failing human and mouse hearts, and that genetic deletion of the MPC in mice leads to cardiac remodeling and dysfunction, the researchers said.

Diets with higher fat content, but enough carbohydrates to limit ketosis also significantly improved heart failure in mice lacking cardiac MPC expression, they said.

"Our study reveals a critical role for mitochondrial pyruvate utilization in cardiac function, and highlights the potential of dietary interventions to enhance cardiac fat metabolism to prevent or reverse cardiac dysfunction and remodeling in the setting of MPC-deficiency,” said Kyle McCommis, PhD, lead author and assistant professor in biochemistry and molecular biology, in a statement.

He said ongoing studies will seek to uncover the importance of ketone body versus fate metabolism in this process of improved cardiac remodeling.