Triglyceride deposit cardiomyovasculopathy (TDCV) is a fairly recently discovered heart condition. As noted in the current research, the condition has to do with a problem with the intracellular breakdown of long-chain triglycerides. Thus, there is a buildup of lipids and energy failure in the heart’s muscle cells and in the vascular smooth muscle cells. Some cases of TDCV have a genetic cause, while the cause is unknown in other cases.

This study compared twenty-two participants who received tricaprin to 190 who did not. All participants had confirmed TDCV and had received their diagnosis at or after age twenty. Participants receiving tricaprin had to meet several inclusion criteria, including experiencing cardiac symptoms that were resistant to standard remedies. There were also several exclusion criteria for receiving tricaprin.

Among participants who received tricaprin, the average age that participants received their diagnoses was around 58 years old.

Participants underwent tests to evaluate myocardial lipolysis or the breakdown of fat by the heart muscle cells.

Individuals who received tricaprin experienced several benefits. For participants who received tricaprin, the tests that reflected fat breakdown suggested that cells in the heart were able to more effectively break down fat after receiving tricaprin compared to participants’ baselines.

Researchers also observed clinical benefits for the group, such as improvement of heart failure symptoms and durable heart failure recovery. Researchers also observed improvements in the left ventricle, including better ejection fraction and reverse remodeling.

In terms of overall survival rates, the tricaprin group had 100% three-year and five-year survival rates. In contrast, the control group had a 78.6% three-year survival rate and a 68.1% five-year survival rate.

When looking only at participants who also had heart failure, which included 14 intervention participants and 128 controls, the tricaprin group again experienced a 100% three-year and five-year survival rate, while the control group’s three-year survival rate was 76.8%, and the five-year survival rate was 64.8%. This analysis excluded participants with NYHA 4, or heart failure stage four because no participants who received tricaprin had this level of heart failure.

Scott C. Feitell, DO, FACC, FHFSA, director of Heart Failure and director of the Cardiac Intensive Care Unit at Rochester Regional, who was not involved in the study, offered the following comments on the study’s findings to Medical News Today:

“This was a very well-designed trial with an excellent analysis done for a small patient population with a rare disease. Based on prior research, the team in this trial extended their proposed treatment model to a larger patient population, compared it to an untreated control arm, and followed patients for a longer period of time. They were able to not only demonstrate marked improvement in ejection fraction by echocardiography once patients received treatment, but they also used a novel radiotracer (I-123 BMIPP) to demonstrate enhanced lipid metabolism in patients on treatment. Most importantly patients felt better and had improved functional class.”

This study did have some limitations, some of which future research may be able to address. For example, this study focused on the Japanese population. Studying the effects in other groups will likely be helpful as research expands in this area.

Additionally, the authors note that it is unclear how newly developed drugs to treat heart failure will affect people who have TGCV and heart failure. Only a small number of participants received these noted medications. Future research may also be able to focus on this.

The data on the left ventricular ejection fraction of one participant with heart failure following tricaprin intervention are unavailable. This measurement is important as it is used to assess the heart’s pumping efficiency in sending oxygen-rich blood to the body.

Additionally, the timing of TGCV diagnosis to participants starting tricaprin varied, which could have introduced bias risk in the research regarding overall survival. However, researchers used a specific method in their sensitivity analysis to try to account for this. While researchers were able to account for some factors in their analysis, it’s possible that some relevant components were missed. Additionally, this study did not involve blinding of participants.

Participants received tricaprin with support from the TGCV/Neutral Lipid Storage Disease (NLSD) Patient Association and had to be requesting assistance from this association. This and other exclusion and inclusion criteria could have affected the sample and who was able to participate.

The Tochino Foundation collaborated with Osaka University to provide the Patient Association with tricaprin for free. The Patient Association also communicated periodically with participants. Additionally, the authors noted several conflicts of interests. All these factors could have affected the study.

The number of participants who received tricaprin was also fairly small, so larger sample sizes with more female participants may also be relevant to future work. Additionally, only three women included in the intervention group had heart failure, and this could have impacted these results. One participant who received tricaprin died 5.3 years after starting tricaprin.

While TGCV is still rare, the authors note that the results may carry over to other individuals. They note that triglycerides are major components of lipid droplets, and lipid droplets are often in people who have heart failure. If future research confirms the findings, tricaprin could benefit people with heart failure in general.

Cardiologist Randy Gould, DO, FACC with Manhattan Cardiology in NYC, who was not involved in the study, noted the following:

“Ticaprin resulted in regression of the triglyceride buildup in the blood vessels of the heart, improved clinical effects on cardiac function and greater survival results.”

“The potential clinical effects of this data is to design future studies to determine if ticarpin has similar cardiovascular effects (TG [triglyceride] regression) in patients with elevated triglyceride levels, but do not have TGCV. If the results show improvement as well, then ticarpin may be an additional treatment option for patients with elevated triglycerides,” he added.