Abstract 11369: Circulating Very Long-Chain Saturated Fatty Acids and Heart Failure

Abstract

Introduction: Myocardial fibrosis with apoptosis contributes to heart failure (HF), and ceramides, with their role in apoptosis, may contribute to this pathophysiological process. However, experimental studies show that ceramides carrying a VLSFA are in fact protective against apoptosis, providing strong evidence that very long-chain saturated fatty acids (VLSFA) impart different biological activity to ceramides. Hypothesis: Circulating VLSFA are associated with lower risk of HF. Methods: We addressed this hypothesis in the Cardiovascular Health Study (CHS), a prospective study of older adults (mean age 72 at entry) with repeated measures of plasma phospholipid fatty acids. Circulating fatty acids were measured at the study baseline in 1992-93, and again where possible, in the 6 th year and 13 th year of follow-up, in plasma phospholipids. We assessed the associations of three VLSFA, arachidic acid (20:0), behenic acid (22:0) and lignoceric acid (24:0), with risk of incident HF using Cox regression with time-dependent covariates and fatty acids. Results: The analyses included 4,060 CHS participants with fatty acid data at least at one time point. During 43,430 person-years, we identified 1228 incident HF. In analyses adjusted for age, sex, race, center, blood pressure, BMI, waist circumference, physical activity, smoking, history of coronary heart disease, atrial fibrillation, diabetes, and current use of antihypertensive medications, higher levels of 22:0 and 24:0 were associated with lower risk of incident HF (Table). With further adjustment for fatty acids previously found to be associated with HF, all three VLSFA were associated with lower risk of incident HF. Conclusions: Higher levels of circulating VLSFA are associated with lower risk of incident HF. These novel findings may open a new avenue of research into these little studied saturated fatty acids and their possible beneficial role in preventing HF.