n-3 Polyunsaturated fatty acids alter expression of fibrotic and hypertrophic genes in a dog model of atrial cardiomyopathy

Ramadeen, Andrew; Laurent, Gabriel; Santos, Claudia C. dos; Hu, Xudong; Connelly, Kim A.; Holub, Bruce J.; Mangat, Iqwal; Dorian, Paul

doi:10.1016/j.hrthm.2009.12.016

Cited by 63 publications

(49 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our previous work suggested that PUFAs (DHA+EPA) may attenuate AF vulnerability by retarding the development of arrhythmogenic structural changes in the atria (inflammation, hypertrophy, and fibrosis) brought on by pacing. 10,13 The …”

Section: Discussionmentioning

confidence: 99%

“…Previous work also has shown that PUFAs alter the tissue response to injury at the genetic level. 13 DHA, but not EPA, has been shown to be a ligand for nuclear receptors, including FXR and RXR, thus possibly affecting gene transcription. 25,28 Other observed differences in DHA and EPA activity that may explain our observations include the ability of DHA, but not EPA, to block certain cardiac ion channels, especially repolarizing potassium channels or membraneincorporated DHA-mediated inhibition of cardiac adrenergic stimulation.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Ramadeen

Connelly

Leong‐Poi

et al. 2012

Circ: Arrhythmia and Electrophysiology

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Ramadeen

Connelly

Leong‐Poi

et al. 2012

Circ: Arrhythmia and Electrophysiology

Self Cite

View full text Add to dashboard Cite

“…34 These electrophysiological properties have been confirmed at the organ level in animal models of atrial remodeling. [35][36][37][38] …”

Section: Potential Mechanisms Of N-3 Polyunsaturated Fatty Acids In Amentioning

confidence: 99%

n-3 Polyunsaturated Fatty Acids in the Prevention of Atrial Fibrillation Recurrences After Electrical Cardioversion

et al. 2011

View full text Add to dashboard Cite

Background-n-3 polyunsaturated fatty acids (n-3 PUFAs) exert antiarrhythmic effects and reduce sudden cardiac death.However, their role in the prevention of atrial fibrillation remains controversial. We aimed to determine the effect of n-3 PUFAs in addition to amiodarone and a renin-angiotensin-aldosterone system inhibitor on the maintenance of sinus rhythm after direct current cardioversion in patients with persistent atrial fibrillation. Methods and Results-We conducted a randomized, double-blind, placebo-controlled, parallel-arm trial in patients with persistent atrial fibrillation, with at least 1 relapse after cardioversion, and treated with amiodarone and a renin-angiotensin-aldosterone system inhibitor. Participants were assigned to placebo or n-3 PUFAs 2 g/d and then underwent direct current cardioversion 4 weeks later. The primary end point was the probability of maintenance of sinus rhythm at 1 year after cardioversion. Of 254 screened patients, 199 were found to be eligible and randomized. At the 1-year follow up, the probability of maintenance of sinus rhythm was significantly higher in the n-3 PUFAs-treated patients compared with the placebo group (hazard ratio, 0.62 [95% confidence interval, 0.52 to 0.72] and 0.36 [95% confidence interval, 0.26 to 0.46], respectively; Pϭ0.0001). Conclusions-In patients with persistent atrial fibrillation on amiodarone and a renin-angiotensin-aldosterone system inhibitor, the addition of n-3 PUFAs 2 g/d improves the probability of the maintenance of sinus rhythm after direct current cardioversion. Our data suggest that n-3 PUFAs may exert beneficial effects in the prevention of atrial fibrillation recurrence. Further studies are needed to confirm and expand our findings. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01198275.

show abstract

“…Atrial tissue was sampled and analyzed for gene expression using a quantitative reverse real-time polymerase chain reaction. Genes related to fibrosis, hypertrophy, and inflammation were found to be down-regulated by the fish oil supplement (Ramadeen et al, 2010). More recently, the same group initiated treatment with EPA + DHA 7 days after simultaneous atrial and ventricular pacing was initiated to induce AF (Ramadeen et al, 2012).…”

Section: New-onset Afmentioning

confidence: 99%

Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?

Schacky¹

2008

Current Opinion in Clinical Nutrition and Metabolic Care

View full text Add to dashboard Cite

This review focuses on developments after 2008, when the topic was last reviewed by the author. Pertinent publications were found by medline searches and in the author's personal data base. Prevention of atrial fibrillation (AF) was investigated in a number of trials, sparked by one positive report on the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), considerations of upstream therapy, data from electrophysiologic laboratories and animal experiments. If EPA + DHA prevent postoperative AF, the effect is probably smaller than initially expected. The same is probably true for maintenance of sinus rhythm after cardioversion and for new-onset AF. Larger trials are currently ongoing. Prevention of ventricular arrhythmias was studied in carriers of an implanted cardioverterdefibrillator, with no clear results. This might have been due to a broad definition of the primary endpoint, including any ventricular arrhythmia and any action of the device. Epidemiologic studies support the contention that high levels of EPA + DHA prevent sudden cardiac death (SCD). However, since SCD is a rare occurrence, it is difficult to conduct an adequately powered trial. In patients with congestive heart failure, EPA + DHA reduced total mortality and rehospitalizations, but not SCD or presumed arrhythmic death. Of three trials in patients after a myocardial infarction, two were inadequately powered, and in one, the dose might have been too low. Taken together, while epidemiologic studies support an inverse relation between EPA + DHA and occurrence of SCD or arrhythmic death, demonstrating this effect in intervention trials remained elusive so far. A pro-arrhythmic effect of EPA + DHA has not been seen in intervention studies, and results of epidemiologic and animal studies also rather argue against such an effect. A different, and probably more productive, perspective is provided by a standardized analytical assessment of a person's status in EPA + DHA by use of the omega-3 index, EPA + DHA in red cell fatty acids. In populations with a high omega-3 index, SCD is rare. Intervention trials can become more effective by including a low omega-3 index into the inclusion criteria, thus creating a study population more likely to demonstrate an effect of EPA + DHA. This is especially relevant in case of rare endpoints, like new-onset AF or SCD.

show abstract

n-3 Polyunsaturated fatty acids alter expression of fibrotic and hypertrophic genes in a dog model of atrial cardiomyopathy

Cited by 63 publications

References 38 publications

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Supplementation Reduces Vulnerability to Atrial Fibrillation

n-3 Polyunsaturated Fatty Acids in the Prevention of Atrial Fibrillation Recurrences After Electrical Cardioversion

Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?

Contact Info

Product

Resources

About