Effects of omega-3 polyunsaturated fatty acids on fibrosis, endothelial function and myocardial performance, in ischemic heart failure patients

  • Author Footnotes
    1 The first two authors E.O. and G.V. equally contributed in this study.
    Evangelos Oikonomou
    Correspondence
    Corresponding author. Vasilissis Sofias 114, 115 28, Hippokration Hospital, Athens Greece. Fax +30 213 2088676.
    Footnotes
    1 The first two authors E.O. and G.V. equally contributed in this study.
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Author Footnotes
    1 The first two authors E.O. and G.V. equally contributed in this study.
    Georgia Vogiatzi
    Footnotes
    1 The first two authors E.O. and G.V. equally contributed in this study.
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Dimitrios Karlis
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Gerasimos Siasos
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School and Harvard, Boston, MA, USA
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  • Christina Chrysohoou
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Theodoros Zografos
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • George Lazaros
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Sotirios Tsalamandris
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Konstantinos Mourouzis
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Georgios Georgiopoulos
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Marina Toutouza
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Dimitris Tousoulis
    Affiliations
    First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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  • Author Footnotes
    1 The first two authors E.O. and G.V. equally contributed in this study.

      Highlights

      • The exact role of Polyunsaturated fatty acids in heart failure patients is unknown.
      • Polyunsaturated fatty acids supplements may improve left ventricle systolic and diastolic performance.
      • These actions may be mediated by endothelial function enhancement and inflammatory status modification.

      Summary

      Background & aims

      Polyunsaturated fatty acids (PUFAs) may affect the cardiovascular system with a multiplicity of mechanisms. We assessed the effects of omega-3 PUFAs supplements on inflammation, fibrosis, left ventricle performance and endothelial function of ischemic heart failure (HF) patients.

      Methods

      In this double-blind, placebo controlled, cross-over trial we enrolled 31 patients with ischemic HF, followed by a 6-week wash-out period. Omega-3 PUFAs (2 g daily, 8 weeks) were administered PO in the intervention arm. Left ventricle ejection fraction (EF), global longitudinal strain and the ratio E/e’ (early ventricular filling to early mitral annulus velocities)were measured. Endothelial function was evaluated by flow mediated dilation and myocardial fibrosis by soluble ST2. High sensitive C Reactive protein (hsCRP) levels were measured as an inflammatory marker.

      Results

      Treatment with omega-3 PUFA, compared to placebo, improved: left ventricle EF (percent increased by 4.7% vs 1.7%); global longitudinal strain (decreased by −10.6% vs −2.3%); the E/e’ ratio (decreased by −9.47% vs −2.1%); ST2 levels (decreased by −4.53% vs −2.37%); flow mediated dilation (percent increased by 44% vs. 11% and hsCRP levels (decreased by −6.13% vs 4.35%) (p < 0.05 for all).

      Conclusion

      Short term treatment with omega-3 PUFAs in subjects with stable ischemic HF improved inflammatory and fibrotic status as well as endothelial function in parallel with systolic and diastolic performance of left ventricle. These findings provide further insights regarding the impact of omega-3 PUFAs administration on left ventricle performance indices, systemic inflammation and fibrosis biomarkers in patients with ischemic HF.

      Graphical abstract

      Keywords

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