Effects of n-3 Polyunsaturated Fatty Acids on Left Ventricular Function and Functional Capacity in Patients With Dilated Cardiomyopathy

Nodari, Savina; Triggiani, Marco; Campia, Umberto; Manerba, Alessandra; Milesi, Giuseppe; Cesana, Bruno Mario; Gheorghiade, Mihai; Dei, Livio

doi:10.1016/j.jacc.2010.11.017

Cited by 185 publications

(151 citation statements)

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“…17 Controlled trials in heart failure patients suggest that omega-3 supplementation may improve LV systolic function. 16,50 These prior studies were limited by modest samples, referral bias, a select focus on people with prevalent disease or use of less robust measures of fish oil intake.…”

Section: Omega-3 Fatty Acids Cardiac Structure and Functionmentioning

confidence: 99%

“…Omega-3 fatty acids also have been related to favorable effects on cardiac function and geometry in experimental models and smaller epidemiological studies, 13,14 and therapeutic administration has demonstrated beneficial effects in the treatment of chronic congestive heart failure in some studies. 15,16 Other PUFAs also have been associated with cardiovascular risk. In particular, the intake of omega-6 fatty acids (primarily linoleic acid (18:2ω-6)) has been associated with reduced cardiovascular risk and with a lower prevalence of future left ventricular (LV) hypertrophy in some studies, 17,18 but the published literature is not conclusive.…”

Section: Introductionmentioning

confidence: 99%

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The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study

et al. 2014

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Polyunsaturated fatty acids have been associated with beneficial influences on cardiovascular health. However, the underlying mechanisms are not clear, and data on the relations of polyunsaturated fatty acids to subclinical disease measures such as vascular stiffness and cardiac function are sparse and inconclusive. In a large community-based cohort, we examined the relations of omega-3 and other fatty acids to a comprehensive panel of vascular function measures (assessing microvascular function and large artery stiffness), cardiac structure and left ventricular function. Red blood cell (RBC) membrane fatty acid composition, a measure of long-term fatty acid intake, was assessed in participants of the Framingham Offspring Study and Omni cohorts and related to tonometry-derived measures of vascular stiffness and to a panel of echocardiographic traits using partial correlations. Up to n=3055 individuals (56% women, mean age 66 years) were available for analyses. In age-and sex-adjusted models, higher RBC omega-3 content was moderately associated (p≤0.002) with several measures of vascular stiffness and function in a protective direction. However, after multivariable adjustment, only an association of higher RBC omega-3 content with lower carotid-femoral pulse wave velocity (a measure of aortic stiffness) remained significant (r = -0.06, p=0.002). In secondary analyses, higher linoleic acid, the major nutritional omega-6 fatty acid, was associated with smaller left atrial size, even after multivariable adjustment (r = -0.064, p<0.001). In conclusion, in our cross-sectional community-based study, we found several associations consistent with the notion of protective effects of omega-3 and linoleic acid. The clinical significance of these modest associations remains to be elucidated.

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Section: Omega-3 Fatty Acids Cardiac Structure and Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study

et al. 2014

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“…A recent randomized controlled trial conducted by Nodari et al [48] evaluated 133 patients with chronic HF secondary to non-ischemic cardiomyopathy and demonstrated significant improvements in many HF and major CV parameters at 12 month follow up in the subjects who received 2 g/ day omega-3 fatty acid supplementation versus placebo Left ventricular ejection fraction in the omega-3 arm was increased by 10.4% compared to a decrease of 5.0% in the placebo arm (p<0.001). Significant improvements in exercise capacity, New York Heart Association functional class, re-hospitalization rates, and inflammatory cytokines were also seen with omega-3 PUFA [48].…”

Section: Evidence In CV Diseasementioning

confidence: 99%

Omega-3 Fatty Acids and Cardiovascular Disease

Lee¹

2013

J Marine Sci Res Dev

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Citation: Lee JH, Prasad A, Jarreau TK, O'Keefe JH, Milani R, et al. (2011) Omega-3 Fatty Acids and Cardiovascular Disease. J Marine Sci Res Development S1:001. doi:10.4172/2155-9910.S1-001Copyright: © 2011 Lee JH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Omega-3 fatty acids provides CV benefits through DHA and EPA enrichment of membrane phospholipids [9] which confers several potentially cardio-protective effects, including an increase arrhythmic thresholds [10], reduction in blood pressure [11,12], improved arterial and endothelial function [13], reduced platelet aggregation [14], and a favorable autonomic balance [11,15]. In a large population study of over 100,000 subjects, omega-3 fatty acid intake was shown to be inversely related to the development of type 2 diabetes in women [16]. A meta-analysis by Geleijnse et al. Omega-3 Fatty Acids and Cardiovascular Disease[17], of 22 double blind studies revealed that omega-3 fatty acid intake of about 4 g/d was associated with significant reductions of 1.7 and 1.5 mm Hg in systolic and diastolic pressures, respectively, an effect that was noted to be more pronounced in older patients and in those with higher baseline blood AbstractThe use of omega-3 fatty acids for the secondary prevention of cardiovascular (CV) events has been endorsed by the American Heart Association. A number of key epidemiologic and randomized trials have been the basis for this recommendation. Initially, the GISSI-Prevenzione and JELIS trials demonstrated significant reductions in CV events with the use of omega-3 fatty acids. More recently,the OMEGA, Alpha Omega, and Kowey et al.[37] studies examining omega-3 supplementation in atrial fibrillation have shown conflicting results. Although more recent trials have not shown the robust benefits that were seen in the earlier ones, the balance of evidence still favor the beneficial effects of omega-3 fatty acids. We would recommend the continuation of omega-3 fatty acids in patients with CV disease and in particular heart failure. Citation: Lee JH, Prasad A, Jarreau TK, O'Keefe JH, Milani R, et al. (2011) Omega-3 Fatty Acids and Cardiovascular Disease. J Marine Sci Res Development S1:001.

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“…To verify these effects, we enrolled 133 patients with chronic HF due to nonischemic dilated cardiomyopathy, EF\45%, stable clinical conditions on evidence-based medical treatment at maximum tolerated target doses for at least 6 months, into a double-blind, placebo-controlled, two-arm study [76]. Participants were randomly allocated to active treatment (1.0 g gelatin capsules containing 850-882 mg of eicosapentaenoic (EPA) and docosahexaenoic (DHA) ethyl esters in the average ratio EPA/DHA of 0.9:1.5) or to placebo (1.0 g gelatin capsules containing olive oil).…”

Section: Antiarrhythmic Effectsmentioning

confidence: 99%

“…DHA is more represented than EPA in myocyte membrane and its administration (alone or in Fig. 1 Variations of the EF in the two study groups (from Nodari [76])…”

Section: Dose and Optimal Ratio Of Dha/epamentioning

confidence: 99%

Effects of supplementation with polyunsaturated fatty acids in patients with heart failure

et al. 2011

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Despite the clinical and prognostic improvement obtained with the current medical treatment, heart failure (HF) continues to have high morbidity and mortality and its prevalence is increasing in most regions of the world. Thus, there is a need for novel adjunctive therapies that act independently of current neurohormonally and haemodynamically oriented drugs. Nutritional approaches are particularly attractive because they could work additively with established therapies without negative hemodynamic effects. There is growing evidence that omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplementation positively impacts established pathophysiological mechanisms in HF and thus has a potential role for preventing and treating HF. The results of the GISSI-HF trial have indicated that, in patients with chronic HF on evidence-based therapy, long term treatment with PUFAs reduced mortality and hospitalizations for cardiovascular reasons, irrespective of etiology and left ventricular (LV) ejection fraction (EF). The purpose of this review is to summarize the evidence emerged from studies conducted so far on the effect of n-3 PUFAs in HF.

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Effects of n-3 Polyunsaturated Fatty Acids on Left Ventricular Function and Functional Capacity in Patients With Dilated Cardiomyopathy

Abstract: In patients with NICM and minimal symptoms in response to evidence-based medical therapy, n-3 PUFAs treatment increases LV systolic function and functional capacity and may reduce hospitalizations for HF. Given these promising results, larger studies are in order to confirm our findings.

Cited by 185 publications

References 19 publications

The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study

The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study

Omega-3 Fatty Acids and Cardiovascular Disease

Effects of supplementation with polyunsaturated fatty acids in patients with heart failure

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