The Association between the Clinical Severity of Heart Failure and Docosahexaenoic Acid Accumulation in Hypertrophic Cardiomyopathy

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a common genetic disease with diverse morphology, symptoms, and prognosis. Hypertrophied myocardium metabolism has not been explored in detail. We assessed the association between myocardium lipid metabolism and clinical severity of heart failure (HF) in HCM using imaging mass spectrometry (IMS). Methods and Results: We studied 16 endomyocardial biopsy (EMB) specimens from patients with HCM. Analysis was conducted using desorption electrospray ionization IMS. The Samples were assigned into two cohorts according to the period of heart biopsy (cohort 1, n=9 and cohort 2, n=7). In each cohort, samples were divided into two groups according to the clinical severity of HF in HCM: clinically severe and clinically mild groups. Signals showing a significant difference between the two groups were analyzed by volcano plot. In cohort 1, the volcano plot identified four signals; the intensity in the clinically severe group was more than twice that of the mild group. Out of the four signals, docosahexaenoic acid (DHA) showed significant differences in intensity between the two groups in cohort 2 (10575.8±2750.3 vs. 19839.3±4803.2, p=0.025). Conclusion: The intensity of DHA was significantly higher in EMB samples from the clinically severe HCM group than in those from the mild group. Funding Information: This study received funding from the Ministry of Education, Science, Sports and Culture of Japan, Grants-in-Aid for Scientific Research (Grant Number 18K08065 [YM]). Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: All the patients provided informed consent. The institutional review board of Hamamatsu University School of Medicine approved all aspects of this study (application number 17-261). The study was conducted in accordance with the regulations of Declaration of Helsinki.