W Stanley
University of Maryland School of Medicine, Baltimore, United States of America

The clinical syndrome of heart failure is complex and has multiple etiologies. Current treatments slow clinical progression, nevertheless prognosis remains poor for most patients. Epidemiological studies find high dietary intake of n-3PUFA from fish oils (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)) is associated with decreased new onset heart failure, and supplementation with a low dose of DHA+EPA increases event free survival in heart failure patients. The underlying mechanisms responsible for these benefits are unclear. DHA and EPA can lower plasma triglyceride levels, and exert anti- inflammatory effects both systemically and in the heart by lowering inflammatory cytokines and depleting arachidonic acid in myocardial phospholipids. Animal studies show fish oil can favorably alter the function of cardiac mitochondria, which is associate with alterations in cardiac phospholipid, specifically an increase in DHA, depletion of arachidonic acid, and elevation of cardiolipin. Moreover, we recently showed improved tolerance to Ca2+ in cardiac mitochondria following supplementation with DHA. There is some evidence to suggest that high intake of α-linolenic acid is cardioprotective in heart failure, but the evidence is limited and not as compelling as with DHA+EPA. In summary, emerging evidence suggests that supplementation with n-3PUFA suppresses established pathophysiological mechanisms in heart failure, and may be effective for preventing and treating this malignant syndrome.

Keywords: N-3 polyunsaturated fatty acid, heart failure
Schlüsselwörter: Omega-3 Fettsäuren, Alphalinolensäure (ALA), EPA, DHA, Herzinsuffizienz