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(Circulation. 2007;115:e545.)
© 2007 American Heart Association, Inc.

Correspondence

Letter by Wiggers et al Regarding Article by Tuunanen et al, "Free Fatty Acid Depletion Acutely Decreases Cardiac Work and Efficiency in Cardiomyopathic Heart Failure"

Henrik Wiggers, MD, PhD; Mads Halbirk, MD

Department of Cardiology, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark

Helene Nørrelund, MD, PhD

Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus, Denmark

To the Editor:

Tuunanen et al¹ report that in patients with heart failure, an acute reduction in circulating free fatty acids depresses cardiac function. These results are different from findings by our group²; they also seem to diverge from observations by Mäki et al.³ We believe that the findings of Tuunanen et al should be interpreted with caution because the results can be biased by limitations in the study design. Both in healthy subjects and in patients, an 8-mL decrease in stroke volume was observed between the initial echocardiography (baseline) and 4 to 5 hours later after treatment with acipimox. A placebo arm was not included; therefore, a potential explanation of the decrease in stroke volume observed in controls and patients is a systematic period effect occurring during the course of the study day.⁴ This is consistent with the duration of the resting state, a decrease in circulating catecholamines, and changes in preload.

	Acknowledgments

 
Disclosures

None.

	References

Top References

 

1. Tuunanen H, Engblom E, Naum A, Nagren K, Hesse B, Airaksinen KE, Nuutila P, Iozzo P, Ukkonen H, Opie LH, Knuuti J. Free fatty acid depletion acutely decreases cardiac work and efficiency in cardiomyopathic heart failure. Circulation. 2006; 114: 2130–2137.[Abstract/Free Full Text]
   
2. Wiggers H, Norrelund H, Nielsen SS, Andersen NH, Nielsen-Kudsk JE, Christiansen JS, Nielsen TT, Moller N, Botker HE. Influence of insulin and free fatty acids on contractile function in patients with chronically stunned and hibernating myocardium. Am J Physiol Heart Circ Physiol. 2005; 289: H938–H946.[Abstract/Free Full Text]
   
3. Mäki M, Luotolahti M, Nuutila P, Iida H, Voipio-Pulkki L, Ruotsalalainen U, Haaparanta M, Solin O, Hartiala J, Harkonen R, Knuuti J. Glucose uptake in the chronically dysfuctional but viable myocardium. Circulation. 1996; 93: 1658–1666.[Abstract/Free Full Text]
   
4. Bairey CN, de Yang L, Berman DS, Rozanski A. Comparison of physiologic ejection fraction responses to activities of daily living: implications for clinical testing. J Am Coll Cardiol. 1990; 16: 847–854.[Abstract]
   

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Circulation 2007 115: 2683. [Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wiggers, H. Articles by Nørrelund, H. Search for Related Content PubMed PubMed Citation Articles by Wiggers, H. Articles by Nørrelund, H. Pubmed/NCBI databases Medline Plus Health Information Cardiomyopathy Heart Failure Related Collections Contractile function Congestive Energy metabolism Related Article