Reduced cardiac remodelling and prevention of glutathione deficiency after omega-3 supplementation in chronic heart failure (original) (raw)
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Arteriosclerosis, Thrombosis, and Vascular Biology, 2003
We reviewed available evidence for cardiovascular effects of n-3 polyunsaturated fatty acid (PUFA) consumption, focusing on long chain (seafood) n-3 PUFA, including their principal dietary sources, effects on physiological risk factors, potential molecular pathways and bioactive metabolites, effects on specific clinical endpoints, and existing dietary guidelines. Major dietary sources include fatty fish and other seafood. n-3 PUFA consumption lowers plasma triglycerides, resting heart rate, and blood pressure and might also improve myocardial filling and efficiency, lower inflammation, and improve vascular function. Experimental studies demonstrate direct antiarrhythmic effects, which have been challenging to document in humans. n-3 PUFA affect a myriad of molecular pathways, including alteration of physical and chemical properties of cellular membranes, direct interaction with and modulation of membrane channels and proteins, regulation of gene expression via nuclear receptors and transcription factors, changes in eicosanoid profiles, and conversion of n-3 PUFA to bioactive metabolites. In prospective observational studies and adequately powered randomized clinical trials, benefits of n-3 PUFA seem most consistent for coronary heart disease mortality and sudden cardiac death. Potential effects on other cardiovascular outcomes are less-well-established, including conflicting evidence from observational studies and/or randomized trials for effects on nonfatal myocardial infarction, ischemic stroke, atrial fibrillation, recurrent ventricular arrhythmias, and heart failure. Research gaps include the relative importance of different physiological and molecular mechanisms, precise dose-responses of physiological and clinical effects, whether fish oil provides all the benefits of fish consumption, and clinical effects of plant-derived n-3 PUFA. Overall, current data provide strong concordant evidence that n-3 PUFA are bioactive compounds that reduce risk of cardiac death. National and international guidelines have converged on consistent recommendations for the general population to consume at least 250 mg/day of long-chain n-3 PUFA or at least 2 servings/week of oily fish. (J Am Coll
ω-3 Fatty Acids and Cardiovascular Diseases: Effects, Mechanisms and Dietary Relevance
ω-3 fatty acids (n-3 FA) have, since the 1970s, been associated with beneficial health effects. They are, however, prone to lipid peroxidation due to their many double bonds. Lipid peroxidation is a process that may lead to increased oxidative stress, a condition associated with adverse health effects. Recently, conflicting evidence regarding the health benefits of intake of n-3 from seafood or n-3 supplements has emerged. The aim of this review was thus to examine recent literature regarding health aspects of n-3 FA intake from fish or n-3 supplements, and to discuss possible reasons for the conflicting findings. There is a broad consensus that fish and seafood are the optimal sources of n-3 FA and consumption of approximately 2-3 servings per week is recommended. The scientific evidence of benefits from n-3 supplementation has diminished over time, probably due to a general increase in seafood consumption and better pharmacological intervention and acute treatment of patients with cardiovascular diseases (CVD).
American heart journal, 2013
Treatment with long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) can improve clinical outcomes in patients with heart failure (HF). Circulating levels of n-3 PUFA, an objective estimation of exposure, have never been measured in a large cohort of patients with HF. We measured n-3 PUFA in plasma phospholipids at baseline and after 3 months in 1,203 patients with chronic HF enrolled in the GISSI-Heart Failure trial and randomized to n-3 PUFA 1 g/daily or placebo. N-3 PUFA levels were related to clinical characteristics, pharmacologic treatments, dietary habits, circulating biomarkers, and mortality. Baseline n-3 PUFA (5.1 ± 1.8 mol%) was associated with dietary fish intake, with an average difference of 43% between patients with the lowest and highest consumptions (P < .0001). Baseline eicosapentaenoic acid (EPA) but not docosahexaenoic acid (DHA) was inversely related to C-reactive protein, pentraxin-3, adiponectin, natriuretic peptide, and troponin levels. Three-month treatm...
Omega3 Polyunsaturated Fatty Acids (Fish Oils) and Heart Disease - Clinical Benefit or Just a Fad?
on human health and disease continues to fascinate researchers in many disciplines. A PubMed search (http://www.ncbi.nlm.nih.gov/sites/entrez) in July 2008 revealed a total of 11,000 articles relating to the effects of "PUFAs, EPA, or DHA" on health. Despite decades of research on the various putative health benefits of a diet rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), believed to be the most important Ω-3 PUFAs contained in fish oils, and the approval of the United States Food and Drug Administration for EPA and DHA as having a qualified health claim for coronary heart disease reduction, 1 there is incomplete consensus on the overall benefits of diets enriched with Ω-3 PUFAs. Different opinions exist on the types of diseases that could potentially be prevented or treated by such dietary enrichment or supplementation, and the potential mechanisms of benefit are particularly in doubt. 2 The lack of clarity on clinical benefit is underscored by the large number of ongoing randomized controlled trials (RCTs) on the effect of Ω-3 PUFAs on cardiac disease (as well as other diseases); as of July 2008, there were at least 246 clinical trials involving Ω-3 PUFAs registered on www.clinicaltrials.gov. Disease conditions under investigation with Ω-3 PUFAs vary widely from mental health disorders, to cancer, to cardiovascular (CV) disease. This issue of Cardiology Rounds reviews the issues and evidence surrounding the debate on Ω-3 PUFAs in heart disease.
Exploring newer cardioprotective strategies: ω-3 fatty acids in perspective
Thrombosis and haemostasis, 2010
In the 1980s, observational retrospective studies showed an inverse relation between coronary heart disease (CHD) and consumption of fish containing fatty acids that belong to the omega (ω)-3 family. Large case-control studies and prospective intervention trials consistently showed that ω-3 fatty acids supplementation lowers fatal myocardial infarction (MI) and sudden cardiac death. By analysing the strengths of the results of individual studies and how the meta-analyses agree with them, putting together relevant backgrounds, and identifying open questions, the following findings/directions emerge. (i) Dietary and non-dietary intake of ω-3 fatty acids reduces overall mortality, mortality due to MI, and sudden death in patients with CHD; (ii) Fish oil consumption directly or indirectly affects cardiac electrophysiology. Fish oil reduces heart rate, a major risk factor for sudden death; (iii) Among patients with implantable cardioverter defibrillators, ω-3 fatty acids do not reduce th...
Biochemistry, 2023
It is a common knowledge that fish is a significant source of docosahexaenoic acid and eicosapentaenoic acid, two long-chain omega-3 fatty acids that have been linked to improve cardiovascular health in general. The cardiac function of humans is benefited by omega-3 fatty acids found in fish eating. Previous studies have shown that eating fish in moderation lowers the risk of coronary heart disease. Recent epidemiological research on the relationship between fish consuming and coronary disease have produced mixed results. Omega-3 fatty acids may not, according to a recent study, lower the incidence of cardiovascular events, strokes, cardiac arrhythmias, or fatalities from coronary heart disease; consequently, it continues to be a contentious issue.
Polskie Archiwum Medycyny Wewnętrznej, 2009
Chronic heart failure (CHF) is a common condition, which despite major advances, is still characterized by high mortality (with sudden arrhythmic death a particular risk), poor quality of life due to exercise intolerance and frequent hospitalizations. Epidemiological studies suggest that populations with a high intake of marine polyunsaturated fatty acids (PUFAs or fish oils) have low levels of cardiovascular mortality. Animal and human studies of fish oil supplementation have demonstrated improved endothelial function and myocardial relaxation, reduced vascular tone and platelet aggregability, and a stabilization of myocyte excitability by prolongation of the refractory period. Marine PUFAs also have potentially important immune-modulating effects, reducing cytokine production and release, and altering prostaglandin metabolism. Data from patients following acute myocardial infarction have suggested that marine PUFA supplementation may reduce early mortality, mostly by reducing the ...
Marine Drugs, 2018
The high-fat diet of North Americans has a major impact on cardiovascular disease occurrence. Notably, fatty acids have been identified as important factors that could modulate such diseases, especially myocardial infarction (MI). Experimentally, omega-3 polyunsaturated fatty acids (PUFA) have demonstrated positive effects on cardiovascular disorders and have also shown cardioprotection by decreasing MI size. Although many animal experiments have clearly established the benefits of omega-3 PUFA, clinical studies have not reached similar conclusions. In fact, the findings of recent clinical investigations indicate that omega-3 PUFA play only a minor role in cardiovascular health. This dichotomy between experimental and clinical studies may be due to different parameters that are not taken into account in animal experiments. We have recently observed that the high consumption of omega-6 PUFA results in significant attenuation of the beneficial effect of omega-3 PUFA on MI. We believe that part of the dichotomy between experimental and clinical research may be related to the quantity of omega-6 PUFA ingested. This review of the data indicates the importance of considering omega-6 PUFA consumption in omega-3 PUFA studies.