Dose-dependent effects of omega-3-polyunsaturated fatty acids on systolic left ventricular function, endothelial function, and markers of inflammation in chronic heart failure of nonischemic origin: a double-blind, placebo-controlled, 3-arm study
Moertl D, Hammer A, Steiner S, Hutuleac R, Vonbank K, Berger R
American heart journal · 96 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2011-05-01 · Am Heart J · vol. 161 · número 5 · págs. 915.e1–915.e9
- Editorial
- Elsevier BV
- Citado
- 124 citas · más que el 99% de estudios similares · 14.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 43 trabajos
- Acceso
- De pago
- Áreas de investigación
- Fatty Acid Research and Health · Heart Failure Treatment and Management · Cardiovascular Function and Risk Factors
- Palabras clave
- omega-3 polyunsaturated fatty acids, chronic heart failure, non-ischemic heart failure, dose-dependent effects, left ventricular ejection fraction, endothelial function, flow-mediated dilation, inflammation, interleukin-6, TNF-α, exercise capacity, omega-3 supplementation, GISSI-HF trial
- MeSH
- endothelium, vascular, humans, fatty acids, omega-3, treatment outcome, follow-up studies, prospective studies, double-blind method, vasodilation, myocardial contraction, systole, ventricular function, left, dose-response relationship, drug, middle aged, female, male, heart failure, biomarkers
6 autores
- Deddo Moertl🇦🇹 · autor de correspondenciaMedical University of Vienna
- Alexandra Hammer🇦🇹Medical University of Vienna
- Sabine Steiner🇦🇹Medical University of Vienna
- Raisa Hutuleac🇦🇹Medical University of Vienna
- Karin Vonbank🇦🇹Medical University of Vienna
- Rudolf Berger🇦🇹Medical University of Vienna
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Supplementation with 1 g/d omega-3-polyunsaturated fatty acids (n3-PUFAs) demonstrated a small survival advantage in patients with chronic heart failure (CHF) in the GISSI-HF trial. However, a dose-efficacy relationship was postulated for the beneficial effects of n3-PUFA before. Therefore, we evaluated dose-dependent effects of n3-PUFA in patients with severe CHF.
Methods
In a double-blind, randomized, controlled pilot trial, 43 patients with severe, nonischemic heart failure received 1 g/d n3-PUFA (n = 14), 4 g/d n3-PUFA (n = 13), or placebo (n = 16) for 3 months. Changes in left ventricular ejection fraction (LVEF), flow-mediated vasodilation, plasma high-sensitive interleukin 6 and high-sensitive tumor necrosis factor α, and exercise peak oxygen consumption were assessed.
Results
Left ventricular ejection fraction increased in a dose-dependent manner (P = .01 for linear trend) in the 4 (baseline vs 3 months [mean ± SD]: 24% ± 7% vs 29% ± 8%, P = .005) and 1 g/d treatment groups (24% ± 8% vs 27% ± 8%, P = .02). Flow-mediated vasodilation increased significantly with high-dose 4 g/d n3-PUFA (8.4% ± 4.8% vs 11.6% ± 7.0%, P = .01) but only trendwise with low-dose 1 g/d (8.3% ± 5.3% vs 10.2% ± 4.3%, P = .07). Interleukin 6 significantly decreased with 4 g/d n3-PUFA (3.0 ± 2.9 pg/mL vs 0.7 ± 0.8 pg/mL, P = .03) but only trendwise with 1 g/d (4.5 ± 6.6 pg/mL to 1.6 ± 2.1 pg/mL, P = .1). High-sensitive tumor necrosis factor α decreased trendwise with 4 g/d n3-PUFA but remained unchanged with 1 g/d. In patients with maximal exercise effort, only 4 g/d increased the peak oxygen consumption. No changes in any investigated parameters were noted with placebo.
Conclusion
Treatment with n3-PUFA for 3 months exerts a dose-dependent increase of LVEF in patients with CHF. In parallel, a significant improvement of endothelial function and decrease of interleukin 6 is found with high-dose n3-PUFA intervention.
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