Journal of Cardiac Failure
Volume 14, Issue 4 , Pages 327-335 , May 2008

Low-Carbohydrate/High-Fat Diet Attenuates Pressure Overload–Induced Ventricular Remodeling and Dysfunction

  • Monika K. Duda, PhD

      Affiliations

    • Division of Cardiology, Department of Medicine, University of Maryland, Baltimore, Maryland
    • Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
  • ,
  • Karen M. O'Shea, BS

      Affiliations

    • Department of Nutrition, Case Western Reserve University, Cleveland, Ohio
  • ,
  • Biao Lei, MD, PhD

      Affiliations

    • Division of Cardiology, Department of Medicine, University of Maryland, Baltimore, Maryland
  • ,
  • Brian R. Barrows, PhD

      Affiliations

    • Division of Cardiology, Department of Medicine, University of Maryland, Baltimore, Maryland
  • ,
  • Agnes M. Azimzadeh, PhD

      Affiliations

    • Department of Surgery, University of Maryland, Baltimore, Maryland
  • ,
  • Tracy E. McElfresh, BS

      Affiliations

    • Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
  • ,
  • Brian D. Hoit, MD

      Affiliations

    • Department of Medicine, Case Western Reserve University, Cleveland, Ohio
  • ,
  • Willem J. Kop, PhD

      Affiliations

    • Division of Cardiology, Department of Medicine, University of Maryland, Baltimore, Maryland
  • ,
  • William C. Stanley, PhD

      Affiliations

    • Division of Cardiology, Department of Medicine, University of Maryland, Baltimore, Maryland
    • Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
    • Department of Nutrition, Case Western Reserve University, Cleveland, Ohio
    • Corresponding Author InformationReprint requests: William C. Stanley, PhD, Division of Cardiology, Department of Medicine, University of Maryland-Baltimore, 20 Penn Street, HSF2, Room S022, Baltimore, MD 21201.

Received 20 July 2007 ,Revised 30 October 2007 ,Accepted 1 November 2007.

References 

  1. Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275:1557–1562
  2. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002;106:3068–3072
  3. Sharma N, Okere IC, Duda MK, Chess DJ, O'Shea KM, Stanley WC. Potential impact of carbohydrate and fat intake on pathological left ventricular hypertrophy. Cardiovasc Res. 2007;73:257–268
  4. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82–96
  5. Halton TL, Willett WC, Liu S, et al. Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med. 2006;355:1991–2002
  6. Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295:655–666
  7. Okere IC, Young ME, McElfresh TA, et al. Low carbohydrate/high-fat diet attenuates cardiac hypertrophy, remodeling, and altered gene expression in hypertension. Hypertension. 2006;48:1116–1123
  8. Sharma N, Okere IC, Duda MK, et al. High fructose diet increases mortality in hypertensive rats compared to a complex carbohydrate or high fat diet. Am J Hypertens. 2007;20:403–409
  9. Okere IC, Chess DJ, McElfresh TA, et al. High-fat diet prevents cardiac hypertrophy and improves contractile function in the hypertensive dahl salt-sensitive rat. Clin Exp Pharmacol Physiol. 2005;32:825–831
  10. Okere IC, Chandler MP, McElfresh TA, et al. Differential effects of saturated and unsaturated fatty acid diets on cardiomyocyte apoptosis, adipose distribution, and serum leptin. Am J Physiol Heart Circ Physiol. 2006;291:H38–H44
  11. Rajapurohitam V, Gan XT, Kirshenbaum LA, Karmazyn M. The obesity-associated peptide leptin induces hypertrophy in neonatal rat ventricular myocytes. Circ Res 200322;93:277–9.
  12. Rajapurohitam V, Javadov S, Purdham DM, Kirshenbaum LA, Karmazyn M. An autocrine role for leptin in mediating the cardiomyocyte hypertrophic effects of angiotensin II and endothelin-1. J Mol Cell Cardiol. 2006;41:265–274
  13. Ilercil A, Devereux RB, Roman MJ, et al. Associations of insulin levels with left ventricular structure and function in American Indians: the strong heart study. Diabetes. 2002;51:1543–1547
  14. Karason K, Sjostrom L, Wallentin I, Peltonen M. Impact of blood pressure and insulin on the relationship between body fat and left ventricular structure. Eur Heart J. 2003;24:1500–1505
  15. Stiefel P, Miranda ML, Rodriguez-Puras MJ, et al. Glucose effectiveness is strongly related to left ventricular mass in subjects with stage I hypertension or high-normal blood pressure. Am J Hypertens. 2004;17:146–153
  16. Rutter MK, Parise H, Benjamin EJ, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation. 2003;107:448–454
  17. Paolisso G, Tagliamonte MR, Galderisi M, et al. Plasma leptin level is associated with myocardial wall thickness in hypertensive insulin-resistant men. Hypertension. 1999;34:1047–1052
  18. Perego L, Pizzocri P, Corradi D, et al. Circulating leptin correlates with left ventricular mass in morbid (grade III) obesity before and after weight loss induced by bariatric surgery: a potential role for leptin in mediating human left ventricular hypertrophy. J Clin Endocrinol Metab. 2005;90:4087–4093
  19. Abel ED. Myocardial insulin resistance and cardiac complications of diabetes. Curr Drug Targets Immune Endocr Metabol Disord. 2005;5:219–226
  20. Matsui T, Rosenzweig A. Convergent signal transduction pathways controlling cardiomyocyte survival and function: the role of PI 3-kinase and Akt. J Mol Cell Cardiol. 2005;38:63–71
  21. Fryer LG, Carling D. AMP-activated protein kinase and the metabolic syndrome. Biochem Soc Trans. 2005;33(Pt 2):362–366
  22. Chan AY, Soltys CL, Young ME, Proud CG, Dyck JR. Activation of AMP-activated protein kinase inhibits protein synthesis associated with hypertrophy in the cardiac myocyte. J Biol Chem. 2004;279:32771–32779
  23. Kovacic S, Soltys CL, Barr AJ, Shiojima I, Walsh K, Dyck JR. Akt activity negatively regulates phosphorylation of AMP-activated protein kinase in the heart. J Biol Chem. 2003;278:39422–39427
  24. Stanley WC, Recchia FA, Lopaschuk GD. Myocardial substrate metabolism in the normal and failing heart. Physiol Rev. 2005;85:1093–1129
  25. Huss JM, Kelly DP. Nuclear receptor signaling and cardiac energetics. Circ Res. 2004;95:568–578
  26. Morgan EE, Faulx MD, McElfresh TA, et al. Validation of echocardiographic methods for assessing left ventricular dysfunction in rats with myocardial infarction. Am J Physiol Heart Circ Physiol. 2004;287:H2049–H2053
  27. Chess DJ, Lei B, Hoit BD, Azimzadeh AM, Stanley WC. Deleterious effects of sugar and protective effects of starch on cardiac remodeling, contractile dysfunction, and mortality in response to pressure overload. Am J Physiol Heart Circ Physiol. 2007;293:H1853–H1860
  28. Lei B, Lionetti V, Young ME, et al. Paradoxical downregulation of the glucose oxidation pathway despite enhanced flux in severe heart failure. J Mol Cell Cardiol. 2004;36:567–576
  29. Belke DD, Betuing S, Tuttle MJ, et al. Insulin signaling coordinately regulates cardiac size, metabolism, and contractile protein isoform expression. J Clin Invest. 2002;109:629–639
  30. Young LH, Dahl DM, Rauner D, Barrett EJ. Physiological hyperinsulinemia inhibits myocardial protein degradation in vivo in the canine heart. Circ Res. 1992;71:393–400
  31. Shiojima I, Yefremashvili M, Luo Z, et al. Akt signaling mediates postnatal heart growth in response to insulin and nutritional status. J Biol Chem. 2002;277:37670–37677
  32. Matsui T, Li L, Wu JC, et al. Phenotypic spectrum caused by transgenic overexpression of activated Akt in the heart. J Biol Chem. 2002;277:22896–22901
  33. Okere IC, Chandler MP, McElfresh TA, et al. Carnitine palmitoyl transferase-I inhibition is not associated with cardiac hypertrophy in rats fed a high-fat diet. Clin Exp Pharmacol Physiol. 2007;34:113–119
  34. Purdham DM, Zou MX, Rajapurohitam V, Karmazyn M. Rat heart is a site of leptin production and action. Am J Physiol Heart Circ Physiol. 2004;287:H2877–H2884
  35. Unger RH. Hyperleptinemia: protecting the heart from lipid overload. Hypertension. 2005;45:1031–1034
  36. Zhou YT, Grayburn P, Karim A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A. 2000;97:1784–1789
  37. Finck BN, Han X, Courtois M, et al. A critical role for PPARalpha-mediated lipotoxicity in the pathogenesis of diabetic cardiomyopathy: modulation by dietary fat content. Proc Natl Acad Sci U S A. 2003;100:1226–1231
  38. Finck BN, Lehman JJ, Leone TC, et al. The cardiac phenotype induced by PPARalpha overexpression mimics that caused by diabetes mellitus. J Clin Invest. 2002;109:121–130
  39. Rupp H, Rupp TP, Maisch B. Fatty acid oxidation inhibition with PPARalpha activation (FOXIB/PPARalpha) for normalizing gene expression in heart failure?. Cardiovasc Res. 2005;66:423–426
  40. Lionetti V, Linke A, Chandler MP, et al. Carnitine palmitoyl transferase-I inhibition prevents ventricular remodeling and delays decompensation in pacing-induced heart failure. Cardiovasc Res. 2005;66:454–461
  41. Hamano T, Kobayashi K, Sakairi T, Hayashi M, Mutai M. Peroxisome proliferator-activated receptor alpha (PPAR alpha) agonist, WY-14,643, increased transcription of myosin light chain-2 in cardiomyocytes. J Toxicol Sci. 2001;26:275–284
  42. Morgan EE, Rennison JH, Young ME, et al. Effects of chronic activation of peroxisome proliferator-activated receptor-alpha or high-fat feeding in a rat infarct model of heart failure. Am J Physiol Heart Circ Physiol. 2006;290:H1899–H1904
  43. Rupp H, Elimban V, Dhalla NS. Sucrose feeding prevents changes in myosin isoenzymes and sarcoplasmic reticulum Ca2+-pump ATPase in pressure-loaded rat heart. Biochem Biophys Res Commun. 1988;156:917–923
  44. Sharma N, Okere IC, Barrows BR, et al. High sugar diets increase cardiac dysfunction and mortality in hypertension compared to low carbohydrate or high starch diets. J Hypertens. 2007;
  45. Correia ML, Morgan DA, Sivitz WI, Mark AL, Haynes WG. Leptin acts in the central nervous system to produce dose-dependent changes in arterial pressure. Hypertension. 2001;37:936–942
  46. Shek EW, Brands MW, Hall JE. Chronic leptin infusion increases arterial pressure. Hypertension. 1998;31(1 Pt 2):409–414
  47. Aizawa-Abe M, Ogawa Y, Masuzaki H, et al. Pathophysiological role of leptin in obesity-related hypertension. J Clin Invest. 2000;105:1243–1252
  48. Astrup A, Meinert LT, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss?. Lancet. 2004;364:897–899

 This research was supported by National Institutes of Health grant HL074237. The authors have no financial disclosures.

PII: S1071-9164(07)01133-5

doi: 10.1016/j.cardfail.2007.11.003

Journal of Cardiac Failure
Volume 14, Issue 4 , Pages 327-335 , May 2008