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Simple Supplement Improves Heart Failure Patients Survival Rates to 100%

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Osaka University researchers found that tricaprin, a natural supplement, significantly improves survival and heart function in TGCV patients, potentially eliminating the need for heart transplants.

Researchers from Osaka University have discovered that tricaprin enhances survival in patients with a newly identified heart disease, triglyceride deposit cardiomyovasculopathy.

A heart transplant is a complex, high-risk, and costly procedure, yet for patients with heart failure, it is sometimes the only treatment option. However, a multi-institutional research team led by Osaka University has discovered that a simple supplement may help certain heart failure patients recover without the need for surgery.

In a study published in Nature Cardiovascular Research, researchers found that tricaprin, a natural supplement, can significantly improve long-term survival and promote recovery in patients with triglyceride deposit cardiomyovasculopathy (TGCV).

TGCV is a newly identified form of heart disease caused by the body’s inability to properly break down triglycerides—fat molecules essential for energy storage. This leads to excessive triglyceride accumulation in heart and smooth muscle cells, resulting in structural and functional damage. Over time, these changes contribute to clogged arteries, weakened heart muscles, and severe heart failure, often requiring transplantation.

Targeting 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 3 years, which eventually required hemodialysis. Her cardiac function completely recovered, along with reverse left ventricular remodeling and was maintained for over 7 years after the initiation of tricaprin. Credit: 2025 Hirano et al., Long-term survival and durable recover of heart failure in patients with triglyceride deposit cardiomyovasculopathy treated with tricaprin. Nature Cardiovascular Research

Breakthrough in Diagnosis and Treatment

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.

Kaplan Meier curves of patients treated with tricaprin: Kaplan-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 dyslipidaemia) was used. Credit: 2025 Hirano et al., Long-term survival and durable recover of heart failure in patients with triglyceride deposit cardiomyovasculopathy treated with tricaprin. Nature Cardiovascular Research

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 Ken-ichi Hirano, the principle investigator for the Japan TGCV study group.

A 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., Long-term survival and durable recover of heart failure in patients with triglyceride deposit cardiomyovasculopathy treated with tricaprin. Nature Cardiovascular Research

All the enrolled patients initially had heart failure; nevertheless, the 3- and 5-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.

Future Research and Implications

“Spreading awareness of this disease to achieve early diagnosis and treatment offers patients the best chance for recovery,” asserts Ken-ichi 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.

Reference: “Long-term survival and durable recovery of heart failure in patients with triglyceride deposit cardiomyovasculopathy treated with tricaprin” by Ken-ichi Hirano, Satomi Okamura, Koichiro Sugimura, Hideyuki Miyauchi, Yusuke Nakano, Kotaro Nochioka, Chikako Hashimoto, Yoshitaka Iwanaga, Kenichi Nakajima, Satoshi Yamaguchi, Yoko Yasui, Shinsaku Shimamoto, Makito Hirano, Mana Okune, Yuki Nishimura, Hisashi Shimoyama, Yasuyuki Nagasawa, Tetsuya Amano, Shimpei Kuniyoshi, Shu-Ping Hui, Nobuhiro Zaima, Yoshihiko Ikeda, Tomomi Yamada, Shinichiro Fujimoto, Yasuhiko Sakata and Kunihisa Kobayashi, 13 February 2025, Nature Cardiovascular Research.
DOI: 10.1038/s44161-025-00611-7

Funding: Ministry of Health, Labour, and Welfare of Japan, Japan Agency for Medical Research and Development

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