High fat diet rewires cardiac metabolism and restores cardiac function experimental heart failure

Abstract Introduction Heart failure is characterized by a metabolic reprogramming changing from fatty acids to glucose as the preferential fuel of the failing myocardium. Whether metabolic reprograming is a therapeutic target remains controversial. Purpose To evaluate whether a nutritional intervention rewiring cardiac metabolism towards a fatty acids has a beneficial effect on cardiac function in a large animal model of hibernated myocardium. Methods Heart failure with reduced ejection fraction (HFrEF ) was induced in pigs by generating a hibernated myocardium secondary to progressive stenosis of the proximal left anterior descending (LAD) after surgical insertion of an ameroid. Pigs underwent a serial multimodality imaging study including magnetic resonance imaging (MRI), PET/CT with 18FDG. Once hibernated myocardium with metabolic reprogramming was documented (complete occlusion of LAD on invasive angiography, LVEF