Omega-3 Index and Anti-Arrhythmic Potential of Omega-3 PUFAs

Abstract

Omega-3 polyunsaturated fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are permanent subjects of interest in relation to the protection of cardiovascular health and the prevention of the incidence of both ventricular and atrial arrhythmias. The purpose of this updated review is to focus on the novel cellular and molecular effects of omega-3 PUFAs, in the context of the mechanisms and factors involved in the development of cardiac arrhythmias; to provide results of the most recent studies on the omega-3 PUFA anti-arrhythmic efficacy and to discuss the lack of the benefit in relation to omega-3 PUFA status. The evidence is in the favor of omega-3 PUFA acute and long-term treatment, perhaps with mitochondria-targeted antioxidants. However, for a more objective evaluation of the anti-arrhythmic potential of omega-3 PUFAs in clinical trials, it is necessary to monitor the basal pre-interventional omega-3 status of individuals, i.e., red blood cell content, omega-3 index and free plasma levels. In the view of evidence-based medicine, it seems to be crucial to aim to establish new approaches in the prevention of cardiac arrhythmias and associated morbidity and mortality that comes with these conditions.

Long-Term Microgravity Exposure Increases ECG Repolarization Instability Manifested by Low-Frequency Oscillations of T-Wave Vector

“…Importantly, the intake of omega-3 fatty acids, which are components of the dietary mix, and their possible protection of cardiovascular health should additionally be viewed in relation to the potentially increased risk for ventricular arrhythmias. Such a relation is, nevertheless, controversial, with some studies suggesting that they have detrimental arrhythmogenic effects, whereas other postulate minimal effects or highly anti-arrhythmic potential (Albert, 2012;von Schacky, 2012;Coronel, 2017;Tribulova et al, 2017). Although one reason to include this type of acid in a dietary support was its protective effects on bones (Zwart et al, 2010), the findings of the present study point out that the dietary mix could not reduce adverse cardiac effects of microgravity simulation.…”

Suppression of β1-Adrenoceptor Autoantibodies is Involved in the Antiarrhythmic Effects of Omega-3 Fatty Acids in Male and Female Hypertensive Rats

“…Indeed, besides the abnormal Cx43 distribution, an increase of β1-AA (i.e., chronic β1-agonistic action) in hypertensive male and female rats was accompanied by a decrease in Cx43 protein level as well as its functional phosphorylated forms at serine368 (Cx43-pS368). Both events have been reported to contribute to malignant arrhythmia propensity by facilitating collapse of both the membrane potential and electrical coupling in various pathophysiological conditions including hypertension [2,16,32,33]. On the other hand, protection against life-threatening arrhythmias was observed by approaches that enhanced Cx43 expression [19] as well as its particular pS368 phosphorylation [24,32,33].…”

“…In conclusion, the current study provides an important step forward in promising manipulation of aberrant β1-AR signaling for suppression of cardiac arrhythmias using the cardioprotective potential of omega-3. It is also challenging to translate such an approach to clinical management of adverse β1-AA actions taken into consideration antiarrhythmic effects of omega-3 in human heart diseases [16].…”

“…Taking into account the pathophysiological role of β1-AA in both HF and life-threatening arrhythmias, the attention is given to the amelioration of β1-AA cardiotoxicity by β1-AR antagonists or immune-adsorption therapy [8,11]. In line with this effort, it is relevant to consider the cardio-protective and antiarrhythmic potential of omega-3 polyunsaturated fatty acids (omega-3) [16][17][18] as a non-invasive and non-pharmacological approach. Omega-3 exerts immuno-modulatory, anti-inflammatory, anti-adrenergic and anti-arrhythmic properties in clinical as well as experimental settings.…”

“…Omega-3 exerts immuno-modulatory, anti-inflammatory, anti-adrenergic and anti-arrhythmic properties in clinical as well as experimental settings. In animals, protection from lethal arrhythmias was mostly attributed to the attenuation of pro-arrhythmogenic substrate, i.e., abnormalities in myocardial intercellular coupling and extracellular matrix (ECM) [16,19]. The question arises whether omega-3 supplementation could reduce lethal arrhythmia risk via counteracting of β1-AA production.…”