A breakthrough discovery from Japanese researchers has revealed that a simple dietary supplement called tricaprin can dramatically reverse heart damage in patients with a rare but deadly form of heart disease. This groundbreaking finding offers new hope for patients with treatment-resistant cardiovascular conditions and represents a completely novel approach to treating heart disease.
The Discovery That Changed Everything
Japanese researchers have uncovered that tricaprin, a dietary supplement, triggered a dramatic reversal of heart disease symptoms in two patients with a rare, treatment-resistant condition. After years of chest pain and failed therapies, the patients experienced relief and even regression of artery-clogging fat deposits.
"Almost 15 years ago, we identified a new type of CAD called triglyceride deposit cardiomyovasculopathy (TGCV), in which the coronary arteries are occluded by triglyceride deposits generated by defective intracellular breakdown of triglycerides in vascular smooth muscle cells," says lead author of the study Ken-ichi Hirano.
What Makes This Different
Unlike typical heart disease caused by cholesterol buildup, TGCV represents an entirely different mechanism. The key wasn't lowering cholesterol, but breaking down triglycerides inside heart cells—a novel and potentially groundbreaking approach to cardiac care.
"While atherosclerosis regression following decreased serum lipid levels is well-described, this is the first report of regression due to increased triglyceride lipolysis within cells, and as such is a conceptually novel treatment for coronary atherosclerosis," says Ken-ichi Hirano.
Understanding TGCV
Triglyceride deposit cardiomyovasculopathy is a rare cardiovascular disorder where the heart and blood vessel cells cannot properly break down fats (triglycerides) inside the cells themselves. This leads to:
- Fat accumulation in heart muscle cells
- Triglyceride deposits in coronary arteries
- Energy failure in the heart
- Severe heart failure
- Treatment-resistant chest pain
In TGCV, defective intracellular lipolysis of long-chain triglycerides (TGs) results in cellular steatosis and energy failure mainly in cardiomyocytes and smooth muscle cells, leading to HF, diffuse coronary artery disease with TG deposition and ventricular arrhythmias with high mortality.
The Remarkable Patient Cases
Two patients in their 60s with severe, treatment-resistant heart disease experienced dramatic improvements after starting tricaprin supplementation:
"Both had suffered from refractory chest pain and diabetes until diagnosis with TGCV, and subsequent dietary intake of tricaprin led to symptom relief."
The results were visible on medical imaging:
- Follow-up coronary computed tomography angiography showed marked regression of atherosclerotic lesions with luminal dilatation
- Fat deposits in artery walls were significantly reduced
- Heart function improved within months
What Is Tricaprin?
Tricaprin is a commercially available food supplement that promotes lipid breakdown by heart muscle cells. It's a type of medium-chain triglyceride (MCT) made from capric acid, a natural fatty acid.
Key characteristics:
- Available as a dietary supplement
- Composed of medium-chain fatty acids
- Helps cells break down stored fats
- Works differently from cholesterol-lowering drugs
The Latest Study: 100% Survival Rate
The most recent research published in Nature Cardiovascular Research in 2025 showed even more remarkable results:
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).
"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 Real-World Success Story
One particularly striking case involved a woman in her 50s:
A woman in her 50s started tricaprin after five hospitalisations 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 haemodialysis. Her cardiac function completely recovered, along with reverse left ventricular remodelling and was maintained for over 7 years after the initiation of tricaprin.
How Does Tricaprin Work?
The supplement works through a unique mechanism:
- Cellular Level Action: Tricaprin helps heart cells break down accumulated triglycerides
- Energy Restoration: This allows cells to produce energy normally again
- Reverse Remodeling: Heart structure and function improve over time
- Artery Clearance: Triglyceride deposits in coronary arteries regress
This study proved the mechanism of CNT-01 to improve myocardial lipolysis in TGCV, as demonstrated by BMIPP scintigraphy.
Important Limitations and Considerations
While these results are remarkable, it's crucial to understand the limitations:
- Specific Condition: These studies focused on TGCV, not typical heart disease
- Small Sample Size: Initial studies involved only a few dozen patients
- Japanese Population: Most research has been conducted in Japanese patients
- Rare Disease: TGCV affects a small subset of heart disease patients
The article title got many of us primed to think this applies to general heart disease but this study was not about typical coronary artery disease (CAD) caused by cholesterol buildup. It focused on a rare condition called triglyceride deposit cardiomyovasculopathy (TGCV).
Who Might Have TGCV?
TGCV is particularly common in:
- Patients with diabetes mellitus
- Those undergoing hemodialysis
- People with treatment-resistant heart disease
- Patients who don't respond to standard cardiac therapies
"Spreading awareness of this disease to achieve early diagnosis and treatment offers patients the best chance for recovery," asserts Ken-ichi Hirano.
The Broader Implications
This research represents several important advances:
Novel Disease Understanding: Recognition of fat metabolism defects as a cause of heart disease
New Treatment Approach: Using supplements to fix cellular metabolism rather than just blocking cholesterol
Diagnostic Tools: Development of specialized imaging to detect triglyceride metabolism problems
Future Research: Given that not all patients respond to current treatments for CAD, the findings from this study pave the way toward establishing a multi-faceted approach to CAD treatment.
What This Means for Patients
For patients with typical heart disease, this research doesn't immediately change treatment recommendations. However, it does suggest:
- Better Diagnosis: More patients with unusual or treatment-resistant heart disease might actually have TGCV
- New Hope: Conditions once considered untreatable may have solutions
- Metabolic Focus: Future heart disease treatments may target cellular metabolism
- Personalized Medicine: Different types of heart disease may require different approaches
Looking Forward
As a next step, studies should be carried out on patients of other ethnicities to support the evidence in favor of this promising drug.
The research team continues to investigate:
- How to identify more TGCV patients
- Whether tricaprin helps other forms of heart disease
- Optimal dosing and treatment protocols
- Long-term safety and effectiveness
The Bottom Line
While tricaprin has shown remarkable results for TGCV patients, it's not a cure-all for heart disease. However, this research represents a paradigm shift in understanding heart disease mechanisms and offers genuine hope for patients with previously untreatable conditions.
"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 story of tricaprin and TGCV reminds us that medical breakthroughs often come from understanding disease at the most basic cellular level. For patients suffering from treatment-resistant heart disease, this research opens new doors to diagnosis and treatment that didn't exist before.
As research continues, we may discover that cellular metabolism plays a much larger role in heart disease than previously understood, potentially revolutionizing how we approach cardiovascular care in the future.
This article is based on peer-reviewed research published in the European Heart Journal and Nature Cardiovascular Research by Dr. Ken-ichi Hirano and colleagues at Osaka University.
