Nodari S, Triggiani M, Campia U, et al. Effects of n-3 polyunsaturated fatty acids on left ventricular function and functional capacity in patients with dilated cardiomyopathy. J Am Coll Cardiol 2011; Presented at the Late Breaking Clinical Trial of the 14th Annual Scientific Meeting of the Heart Failure Society of America, September 12–15, 2010, San Diego, California.
DOI: 10.1016/j.jacc.2010.11.017
http://content.onlinejacc.org/cgi/content/abstract/j.jacc.2010.11.017v1
http://content.onlinejacc.org/cgi/content/full/j.jacc.2010.11.017v1
http://content.onlinejacc.org/cgi/reprint/j.jacc.2010.11.017v1
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related editorial:
Tang W, Samara M. Polyunsaturated fatty acids in heart failure: Should we give more and give earlier? J Am Coll Cardiol 2011; DOI: 10.1016/j.jacc.2010.11.014.
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J Am Coll Cardiol, doi:10.1016/j.jacc.2010.11.017 (Published online 5 January 2011)
© 2011 by the American College of Cardiology Foundation
EXPEDITED PUBLICATION
Effects of n-3 Polyunsaturated Fatty Acids on Left Ventricular Function and Functional Capacity in Patients With Dilated Cardiomyopathy
Savina Nodari, MD*, Marco Triggiani, MD*, Umberto Campia, MD, Alessandra Manerba, MD*, Giuseppe Milesi, MD*, Bruno M. Cesana, MD, Mihai Gheorghiade, MD,* and Livio Dei Cas, MD*
* Department of Experimental and Applied Medicine–Section of Cardiovascular Diseases, University of Brescia, Brescia, Italy
Section of Medical Statistics and Biometry, Department of Biomedical Sciences and Biotechnologies, University of Brescia, Brescia, Italy
Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Manuscript received August 26, 2010; revised manuscript received November 1, 2010, accepted November 9, 2010.
* Reprint requests and correspondence: Dr. Mihai Gheorghiade, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 1006, Chicago, Illinois 60611 (Email: m-gheorghiade@northwestern.edu).
Presented at the Late Breaking Clinical Trial of the 14th Annual Scientific Meeting of the Heart Failure Society of America, September 12–15, 2010, San Diego, California.
Objectives: This study was designed to test the effects of n-3 polyunsaturated fatty acids (PUFAs) on left ventricular (LV) systolic function in chronic heart failure (HF) due to nonischemic dilated cardiomyopathy (NICM).
Background: One hundred thirty-three patients with NICM and minimal symptoms on standard therapy were randomized to 2 g of n-3 PUFAs or placebo. LV function and functional capacity were assessed prospectively by echocardiography and cardiopulmonary exercise testing at baseline and at 12 months after randomization.
Methods: Patients with chronic HF due to NICM and minimal symptoms while receiving evidence-based therapy were enrolled. LV function and functional capacity were assessed prospectively by echocardiography, cardiopulmonary exercise test, and New York Heart Association functional class at baseline and at 12 months after randomization to either 2 g of n-3 PUFAs or placebo.
Results: At 12 months after randomization, the n-3 PUFAs group and the placebo group differed significantly (p <0.001) in regard to: 1) LV ejection fraction (increased by 10.4% and decreased by 5.0%, respectively); 2) peak VO2 (increased by 6.2% and decreased by 4.5%, respectively); 3) exercise duration (increased by 7.5% and decreased by 4.8%, respectively); and 4) mean New York Heart Association functional class (decreased from 1.88 ± 0.33 to 1.61 ± 0.49 and increased from 1.83 ± 0.38 to 2.14 ± 0.65, respectively). The hospitalization rates for HF were 6% in the n-3 PUFAs and 30% in the placebo group (p = 0.0002).
Conclusions: In patients with NICM and minimal symptoms in response to evidence-based medical therapy, n-3 PUFAs treatment increases LV systolic function and functional capacity and may reduce hospitalizations for HF. Given these promising results, larger studies are in order to confirm our findings.
Key Words: cardiomyopathy • functional capacity • heart failure • nonischemic myocardial function • n-3 PUFAs • NYHA functional class