Abstract
Heart failure (HF) characterized by cardiac remodeling is a condition in which inflammation and fibrosis play a key role. Dietary supplementation with n-3 polyunsaturated fatty acids (PUFAs) seems to produce good results. In fact, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory and antioxidant properties and different cardioprotective mechanisms. In particular, following their interaction with the nuclear factor erythropoietin 2 related factor 2 (NRF2), the free fatty acid receptor 4 (Ffar4) receptor, or the G-protein coupled receptor 120 (GPR120) fibroblast receptors, they inhibit cardiac fibrosis and protect the heart from HF onset. Furthermore, n-3 PUFAs increase the left ventricular ejection fraction (LVEF), reduce global longitudinal deformation, E/e ratio (early ventricular filling and early mitral annulus velocity), soluble interleukin-1 receptor-like 1 (sST2) and high-sensitive C Reactive protein (hsCRP) levels, and increase flow-mediated dilation. Moreover, lower levels of brain natriuretic peptide (BNP) and serum norepinephrine (sNE) are reported and have a positive effect on cardiac hemodynamics. In addition, they reduce cardiac remodeling and inflammation by protecting patients from HF onset after myocardial infarction (MI). The positive effects of PUFA supplementation are associated with treatment duration and a daily dosage of 1–2 g. Therefore, both the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA) define dietary supplementation with n-3 PUFAs as an effective therapy for reducing the risk of hospitalization and death in HF patients. In this review, we seek to highlight the most recent studies related to the effect of PUFA supplementation in HF. For that purpose, a PubMed literature survey was conducted with a focus on various in vitro and in vivo studies and clinical trials from 2015 to 2021.
Highlights
There are numerous cases of hospitalization linked to Heart failure (HF); for this reason, there are many studies aimed at finding an effective therapy, especially a non-pharmacological preventive therapy
Clinical and in vitro studies indicate that the positive outcomes of dietary supplementation with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the HF onset and management are related to the duration of treatment and dosage
It is clear that a diet with a more controlled polyunsaturated fatty acids (PUFAs) intake can contribute to the improvement of inflammatory pharmacological preventive therapy
Summary
Inflammation determines the presence of immune cells in the heart tissue a preserved ejection fraction (HFpEF). Both cardiac inflammation and fibrosis are being studied in numerous animal brosis, extracellular matrix proteins are more abundant and show structural and funcmodels, as they could be the target of new heart failure therapies [3]. Both cardiac and fibrosis are being studiedheart in numerous clinical studies conducted overinflammation the years in patients with acute and chronic failure animal models, as they could be the target of new heart failure therapies. There is altered function of the endoplasmic reticulum, reduced nitric oxide (NO) release, metalloproteinase (MMP) dysregulation, and a change in cardiac stem cell mobilization All of this determines an increase in the left ventricle’s stiffness, generating diastolic dysfunction [5]. In this review, we want to highlight the most recent studies related to the effect of PUFA supplementation in heart failure
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