Omega-3 fatty acid blood levels are inversely associated with cardiometabolic riskfactors in HFpEF patients

Abstract

Objectives:To evaluate the association of Omega-3 fatty-acid (O3-FA) blood levels with cardiometabolic risk markers, functional capacity and cardiac function/morphology in HFpEF patients.Background:O3-FA demonstrated favorable effects on heart failure and associated phenotypic traits in experimental/clinical studies. In patients with heart failure with preserved ejection fraction (HFpEF), the association of O3-FA status with patient characteristics is unknown.Methods:This is a cross-sectional analysis of baseline data from the Aldo-DHF-RCT. From 422 patients, the omega-3-index (O3I=EPA+DHA) was analyzed in n=404 using the HS-Omega-3-Index® methodology. Patient characteristics were; 67±8 years, 53% female, NYHA II/III (87/13%), ejection fraction ≥50%, E/e´ 7.1±1.5; median NT-proBNP 158 ng/L (IQR 82-298). Pearson's correlation coefficient was used to describe associations of the O3I with metabolic phenotype, exercise capacity, echocardiographic markers for LVDF, and neurohumoral activation.Results:The O3I was below(<8%)/within(8-11%)/higher >11%) than the target range in 374 (93%)/29 (7%)/1 (0.2%) patients respectively. Mean O3I was 5.7±1.7%. The O3I was inversely associated with HbA1c (r=-0.139, p=0.006), triglycerides-to-HDL-C ratio (r=-0.12, p=0.017), triglycerides (r=-0.117, p=0.02), non-HDL-C (r=-0.101, p=0.044), body-mass-index (r=-0.149, p=0.003), waist circumference (r=-0.121, p=0.015), waist-to-height ratio (r=-0.141, p=0.005), and positively associated with submaximal aerobic capacity (r=0.113, p=0.023) and LVEF (r=0.211, p<0.001). We did not observe an association between the =3I and maximal functional capacity, echocardiographic markers of LVDF or NT-proBNP.Conclusions:Higher O3I was associated with a more favorable cardiometabolic risk profile and better submaximal aerobic capacity in HFpEF patients but did not correlate with echocardiographic markers for left ventricular filling pressures, left ventricular relaxation or neurohumoral activation.