A simple supplement can improve survival in patients with a novel heart disease

by Osaka University

A simple supplement improves survival in patients with a new type of heart diseaseTargeting cardiomyocyte steatosis cures heart failure: Heart failure is a pandemic in the aging population. Targeting myocardial long-chain triglyceride in lipid droplets by another triglyceride, tricaprin, could sustain and recover patients’ hearts, which is a practical SDG for human health. A woman in her 50s started tricaprin after five hospitalizations for progressive heart failure during the prior 18 months, even receiving multiple drugs for HF. She had a medical history of progressive chronic kidney disease for three years, which eventually required hemodialysis. Her cardiac function completely recovered, along with reverse left ventricular remodeling and was maintained for over seven years after the initiation of tricaprin. Credit: 2025 Hirano et al., Nature Cardiovascular Research

Heart transplant is a scary and serious surgery with a high cost, but for patients with heart failure it can be the only option for cure. Now, however, a multi-institutional research team led by Osaka University has found that simply taking a supplement might be all that is needed for certain patients with heart failure to recover—no surgery needed.

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In a study published in Nature Cardiovascular Research, the research team found that tricaprin, a natural supplement, can improve long-term survival and recovery from heart failure in patients with triglyceride deposit cardiomyovasculopathy (TGCV).

TGCV is a new type of heart disease; it results from an impaired ability of the heart and smooth muscle cells to break down triglycerides, which are a type of fat. Triglyceride accumulation in cells causes structural and functional damage in the heart and blood vessels. These changes result in clogged arteries and weakened heart muscles, which may cause debilitating symptoms and eventually heart failure, necessitating heart transplantation.

Luckily, through a series of experiments, researchers have identified how to diagnose the disease and developed a treatment that improves both disease symptoms and prognosis.

“Our previous research on the effect of tricaprin on patients with TGCV was very promising, but this time we decided to study how long the positive effects of the drug held up,” says lead author of the study Ken-ichi Hirano.

A simple supplement improves survival in patients with a new type of heart diseaseKaplan-Meier curve of patients treated with tricaprin compared with all (left) and matched controls (right) not treated with tricaprin. Adjusted HR was estimated by the Cox model including sex, age at diagnosis, coronary artery disease, heart failure, and ventricular arrhythmia, and dyslipidemia. The propensity score matching method (matching variable: sex, age at diagnosis, coronary artery disease, heart failure, ventricular arrhythmia, and dyslipidemia) was used. Credit: Nature Cardiovascular Research (2025). DOI: 10.1038/s44161-025-00611-7

To achieve this, the researchers enrolled patients diagnosed with the condition from Japanese registries and compared the survival rates between those who had received tricaprin and those who did not. The study involved 22 patients from 12 different hospitals who had received tricaprin and 190 controls.

The researchers studied the effect of tricaprin on triglyceride breakdown; to overcome differences in the compared groups, 81 of the 190 controls were matched with the tricaprin group according to their baseline characteristics for comparison of survival rates.

“Not only did the positive effects on patient symptoms continue, but the function of the heart muscle improved and the structural changes that had developed were reversed as well,” says Hirano, the principal investigator for the Japan TGCV study group.

All the enrolled patients initially had heart failure; nevertheless, the three- and five-year survival rates were significantly higher in the tricaprin group (100% and 100%, respectively) compared with the control group (78.6% and 68.1%, respectively). Another favorable result was that several patients who had positive effects with tricaprin were on hemodialysis. These patients have a very poor prognosis without tricaprin.

A simple supplement improves survival in patients with a new type of heart diseaseA hypothetical model of the detailed mechanism of action of tricaprin Given that beneficial effects of tricaprin were observed in ATGL-knockout mice, these effects are likely to be ATGL-independent. Capric acid (C10:0), the fatty-acid component of tricaprin, may play a key role in altering both substrates and enzymes involved in intracellular TG hydrolysis. Capric acid (C10:0) is incorporated into the TG pool to form chimeric TG with long-chain fatty acid. TG with C10:0 is preferentially hydrolyzed by enzymes (i.e. carboxy-esterase) possessing lipolytic activities other than ATGL. Abbreviations: ATGL, adipose triglyceride lipase; C10:0, capric acid; LCFA, long-chain fatty acid; TG, triglyceride; TGCV, triglyceride deposit cardiomyovasculopathy. Credit: 2025 Hirano et al., Nature Cardiovascular Research

“Spreading awareness of this disease to achieve early diagnosis and treatment offers patients the best chance for recovery,” says Hirano.

These study findings are based on data from Japanese patients. As a next step, studies should be carried out on patients of other ethnicities to support the evidence in favor of this promising drug. This new research delivers the hope that patients can not only sustain but also recover their hearts from debilitating heart failure.

More information: Ken-ichi Hirano et al, Long-term survival and durable recovery of heart failure in patients with triglyceride deposit cardiomyovasculopathy treated with tricaprin, Nature Cardiovascular Research (2025). DOI: 10.1038/s44161-025-00611-7

Journal information:Nature Cardiovascular Research

Provided by Osaka University


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