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

Narcis Tribulova,Barbara Szeiffova Bacova,Miroslav Barancik,Jan Slezak,Vladimir Knezl,Tamara Egan Benova

doi:10.3390/nu9111191

Narcis Tribulova, Barbara Szeiffova Bacova + Show 4 more

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https://doi.org/10.3390/nu9111191

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Journal: Nutrients	Publication Date: Oct 30, 2017
Citations: 44	License type: CC BY 4.0

Affiliation: Slovak Academy of Sciences

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.

Highlights

Omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are permanent subjects of interest in relation to the protection of cardiovascular health, supported by an increasing number of both experimental and clinical studies, published in the last decade
Experimental studies included in this review have demonstrated numerous mechanisms, by which circulating and incorporated omega-3 PUFAs may act at the cellular and molecular levels, including genetic and epigenetic modulations
A subset of patients participating in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Heart Failure (HF) study treated with omega-3 PUFAs (1 g/day) exhibited an increase in the Omega-3 Index (O3I) from 4.8 ± 1.7% to 6.7 ± 1.9% [13]

Summary

Introduction

Omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are permanent subjects of interest in relation to the protection of cardiovascular health, supported by an increasing number of both experimental and clinical studies, published in the last decade. A subset of patients participating in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Heart Failure (HF) study treated with omega-3 PUFAs (1 g/day) exhibited an increase in the O3I from 4.8 ± 1.7% to 6.7 ± 1.9% [13] This may explain the observed benefits with respect to cardiovascular events, despite the fact that the target levels were not achieved. Such an increase seems to be insufficient to suppress the incidence of malignant arrhythmias significantly, according to the results from the sub-study of GISSI-HF on patients with ICD [14]. Monitoring of both the O3I and plasma levels may reflect the actual status of the omega-3 PUFAs that should always be considered with respect to their effects

Mechanisms and Factors Involved in the Development of VF and AF

Potential Targets of Omega-3 PUFAs Relevant to Arrhythmias Prevention

Omega-3 PUFAs and Prevention of AF and POAF

Omega-3 PUFAs and Prevention of Malignant Ventricular Arrhythmias

Findings

Conclusions