Abstract

Abdominal aortic aneurysm (AAA) is a vascular disease involving permanent focal dilation of the abdominal aorta (≥30 mm) that can lead to catastrophic rupture. Destructive remodeling of aortic connective tissue in AAA contributes to wall stiffening, a mechanical parameter of the arterial system linked to a heightened risk of cardiovascular morbidity and mortality. Since aortic stiffening is associated with AAA progression, treatment options that target vascular inflammation would appear prudent. Given this, and growing evidence indicating robust anti-inflammatory and vasoprotective properties for long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs), this study evaluated the impact of these nutrients (1.8 g/day for 12 weeks) on indices of vascular stiffness in patients with AAA. At baseline, pulse wave velocity (PWV) and augmentation index normalized to a heart rate of 75 bpm (AIx75) were significantly higher in patients with AAA compared to control participants (PWV: 14.2 ± 0.4 m.s−1 vs. 12.6 ± 0.4 m.s−1, p = 0.014; AIx75: 26.4 ± 1.7% vs. 17.3 ± 2.7%, p = 0.005). Twelve-week LC n-3 PUFA supplementation significantly decreased PWV (baseline: 14.2 ± 0.6 m.s−1, week 12: 12.8 ± 0.7 m.s−1, p = 0.014) and heart rate (baseline: 63 ± 3 bpm, week 12: 58 ± 3 bpm, p = 0.009) in patients with AAA. No change was observed for patients receiving placebo capsules. While this raises the possibility that LC n-3 PUFAs provide improvements in aortic stiffness in patients with AAA, the clinical implications remain to be fully elucidated.

Highlights

  • Abdominal aortic aneurysm (AAA) is a clinically silent cardiovascular disease characterized by permanent and progressive full thickness dilation of the abdominal aortic segment [1]

  • pulse wave velocity (PWV) and AIx75 measurements were significantly higher in patients with AAA compared to the healthy control cohort (PWV: 14.2 ± 0.4 m.s−1 vs. 12.6 ± 0.4 m.s−1, p = 0.014; AIx75: 26.4 ± 1.7% vs. 17.3 ± 2.7%, p = 0.005)

  • AAA Is a Significant Independent Determinant of PWV Linear regression analysis highlighted a significant association between PWV and AAA (β = 0.463, 95% CI: 0.426 to 3.248, p = 0.012) following adjustment for covariates shown to be imbalanced between the control and AAA cohorts

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Summary

Introduction

Abdominal aortic aneurysm (AAA) is a clinically silent cardiovascular disease characterized by permanent and progressive full thickness dilation of the abdominal aortic segment [1]. Alterations in vessel stiffness can be monitored using non-invasive techniques that measure the speed of forward traveling pulse waves (carotid to femoral pulse wave velocity, PWV) [8] or that analyze arterial pressure wave reflection characteristics (pulse wave analysis, PWA) [9]. The latter provides an augmentation index (AIx), a parameter that reflects aortic pressure augmentation relative to pulse pressure [10]. AIx is influenced by the structure and degree of compliance of vessels distal to measurement sites [11]

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