Dietary Supplementation Of Extra Virgin Olive Oil In Patients With Heart Failure With Preserved Ejection Fraction Is Associated With Increases In Cardiorespiratory Fitness

Introduction Prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) is increasing worldwide, without effective therapies to reduce morbidity and mortality. Supplementation of extra virgin olive oil (EVOO) is a powerful primary prevention strategy against major cardiovascular events, but its effect on secondary prevention in HFpEF is unknown. Cardiorespiratory fitness (CRF), measured by peak oxygen consumption (VO2) on cardiopulmonary exercise testing (CPET), is a strong prognostic marker in HFpEF and increases in peak VO2 are linked to reductions in mortality. Our aim was to assess the effect of EVOO supplementation on measures of CRF in patients with HFpEF. Methods Nine consecutive patients were enrolled in the UFA-Preserved trial (NCT03310099), a dietitian-led 12-week pilot trial supplementing unsaturated fatty acid (UFA) rich foods, such as EVOO, in patients with HFpEF. Five-pass 24-hour dietary recalls were performed at baseline, 4, 8 and 12 week visits and analyzed with Nutrition Data Systems for Research (NDSR) software. Intake of EVOO in grams (g) was averaged across the 4, 8 and 12 week visits and average change from baseline was calculated. Peak VO2(mL.kg.min−1) and percent predicted value (% peak VO2) were measured with maximal CPET at baseline and 12 weeks along with oxygen uptake efficiency slope (OUES). Relationships between variables were analyzed with Spearman\u0027s rank test. Results are presented as median and interquartile range (IQR). Results Five subjects were female (56%) with a median age of 56 (50- 59) years. Baseline peak VO2 was 14.7 mL.kg.min−1 (11.3-22.1), % peak VO2 was 51.4 (43.8-59.4) and OUES was 1.87 (1.46-2.39). There was no EVOO intake on baseline dietary recalls, an increase in daily EVOO +23.6 g (12.0-47.6) (p=0.012) was observed between baseline and 12 weeks. EVOO consumption was significantly associated with positive improvements in peak VO2 (r=+0.850, p=0.004), % peak VO2 (r=+0.850, p=0.004), and OUES (r=+0.733,p=0.025) (Figure 1, panels A-C). Conclusion Dietary EVOO supplementation results in increased CRF in patients with HFpEF with no EVOO baseline intake. Further studies are warranted to confirm this finding and establish a basis for testing the effect of EVOO on CRF as well as major cardiovascular outcomes and to explore these effects across differing baseline intakes of EVOO.