Abstract
Proper nutrition helps protect from illness and disease. Choline (Ch), an essential molecule of substantial importance for the optimal development and function of several biological systems, plays a crucial role in the pathway of one-carbon metabolism. On the other hand, Ch-deprivation (CD) has been linked with abnormal fat metabolism, insulin resistance, and myocardial dysfunction. The Ch-deficiency setting is an established experimental model of non-alco¬holic steatohepatitis that resembles the human non-alcoholic fatty liver disease (NAFLD); a disease with constantly increasing incidence and prevalence. NAFLD, commonly associated with metabolic comorbidities such as obesity and type 2 diabetes mellitus, consists a high risk for cardiovascular disease. Experimental data of dietary CD through the administration of a Ch-deficient diet to rodents have revealed myocardial monocyte infiltration along with cardiac interstitial oedema and fibrosis, as well as a deleterious effect on cardiac valves that could lead to impaired heart mechanical properties which resemble to a restrictive pattern of cardiomyopathy characterised mainly by diastolic dysfunction. In a Ch-deprived diabetic experimental model, the diastolic heart failure has been characterized by a concentric hypertrophied myocardium, a left ventricular cavity with a thinner wall, and an increased left ventricular diastolic diameter, in addition to a left atrial dilatation that could also exert functional derangement and provoke arrhythmogenesis, thereby jeopardising cardiac output.