Fatty acid composition in chronic heart failure: low circulating levels of eicosatetraenoic acid and high levels of vaccenic acid are associated with disease severity and mortality

Abstract

Abstract. Øie E, Ueland T, Dahl CP, Bohov P, Berge C, Yndestad A, Gullestad L, Aukrust P, Berge RK (Research Institute for Internal Medicine, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Center for Heart Failure Research, University of Oslo, Oslo, Section of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Faculty of Medicine, University of Oslo, Oslo, Section of Medical Biochemistry, Institute of Medicine, University of Bergen, Bergen, Department of Heart Disease, Haukeland University Hospital, University of Bergen, Bergen; and Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo; Norway). Fatty acid composition in chronic heart failure: low circulating levels of eicosatetraenoic acid and high levels of vaccenic acid are associated with disease severity and mortality. J Intern Med 2011; 270: 263-272.Objectives. Free fatty acids (FFAs) are the major energy sources of the heart, and fatty acids (FAs) are active components of biological membranes. Data indicate that levels of FAs and their composition may influence myocardial function and inflammation. The aim of this study was to investigate whether total levels and composition of FAs and FFAs in plasma are altered in clinical heart failure (HF) and whether any alterations in these parameters are correlated with the severity of HF. Subjects.Plasma from 183 patients with stable HF was compared with plasma from 44 healthy control subjects.Results. Our main findings are as follows: (i) patients with HF had decreased levels of several lipid parameters and increased levels of FFAs in plasma, compared with controls, which were significantly correlated with clinical disease severity. (ii) Patients with HF also had a decreased proportion in the plasma of several n-3 polyunsaturated FAs, an increased proportion of several monounsaturated FAs, and a decreased proportion of some readily oxidized longchain saturated FAs. (iii) These changes in FA composition were significantly associated with functional class, impaired cardiac function (i.e., decreased cardiac index and increased plasma N-terminal pro-Btype natriuretic peptide levels) and enhanced systemic inflammation (i.e., increased high-sensitivity C-reactive protein levels). (iv) Low levels of C20:4n-3 (eicosatetraenoic acid) and in particular high levels of C18:1n-7 (vaccenic acid) were significantly associated with total mortality in this HF population.Conclusions. Our data demonstrate that patients with HF are characterized by a certain FA phenotype and may support a link between disturbed FA composition and the progression of HF.

Free fatty acids and cardiovascular outcome: a Chinese cohort study on stable coronary artery disease

“…In our study, we also found positive association between FFAs and FPG ( r  = 0.239, P  < 0.05), HbA1c ( r  = 0.215, P  < 0.05), which was in consistent with previous studies [22–24]. Moreover, high level of FFAs was also found to play a role in arrhythmia [25, 26] and myocardial dysfunction [27–29]. Thereby, studies on the role of FFAs in predicting for atherosclerotic cardiovascular disease are benefit for improving strategies for prevention and therapy in CAD.…”

Plasma Free Fatty Acids and Risk of Heart Failure

“…A cross-sectional study showed that HF patients have higher plasma FFA than controls 27 . In animal models, FFA were associated with cardiac dysfunction and such effect was eliminated upon treatment with fibrates 28 .…”

Plasma phospholipid fatty acid composition and estimated desaturase activity in heart failure patients with metabolic syndrome

“…(18,19) This was in part supported by a study showing the association of the elevated plasma levels of SFA and reduced plasma levels of DHA with the risks of HF. (20) Moreover, Oie et al (21) and Zhao et al (22) compared the changes in FA composition between the normal control and HF subjects and found out the roles of monounsaturated fatty acids (MUFAs) and some PUFA in HF subjects. They demonstrated that high levels of MUFA and linoleic acid and low levels of arachidonic acid were associated with those subjects.…”

“…They demonstrated that high levels of MUFA and linoleic acid and low levels of arachidonic acid were associated with those subjects. (21,22) In addition, it was reported that EPA and DHA are negatively correlated with heart rate, indicating that low proportion of either EPA or DHA increases a chance to elevate heart rate. (23) …”