Red blood cell omega-3 fatty acids and the risk of ventricular arrhythmias in patients with heart failure
Background Epidemiological studies support the protective effect of omega-3 fatty acids on sudden cardiac death. However, patients with structural heart disease and an implantable cardioverter defibrillator (ICD) showed no effect or even a proarrhythmic response to fish oil supplementation. Animal s...
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| Veröffentlicht in: | The American heart journal 2008-06, Vol.155 (6), p.971-977 |
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| creator | Wilhelm, Matthias, MD Tobias, Rueth Asskali, Fatima, MD Kraehner, Robert, MD Kuly, Simone, MD Klinghammer, Lutz, MD Boehles, Hansjosef, MD Daniel, Werner Guenther, MD |
| description | Background Epidemiological studies support the protective effect of omega-3 fatty acids on sudden cardiac death. However, patients with structural heart disease and an implantable cardioverter defibrillator (ICD) showed no effect or even a proarrhythmic response to fish oil supplementation. Animal studies suggest different electrophysiologic effects of circulating and incorporated omega-3 fatty acids. Methods In 102 ICD patients in New York Health Association functional class II or III, the fatty acid composition of red blood cells was analyzed by gas chromatography. The omega-3 index was calculated from eicosapentaenoic acid and docosahexaenoic acid. Patients were followed for 1 year, and ventricular arrhythmias requiring antitachycardic therapy were analyzed. Twenty-five healthy subjects served as control. Results In ICD patients, the fatty acid profile was significantly altered and the baseline omega-3 index was significantly elevated, as compared to control subjects (5.12% ± 0.87% vs 4.24% ± 0.96%, P < .001). Kaplan-Meier estimates of probability of ventricular arrhythmias showed significant differences among quartiles of the omega-3 index. Twelve percent of patients in the lowest quartile had ventricular arrhythmias, as compared to 54% of patients in the highest quartile ( P = .022). In a multivariate analysis, the omega-3 index was the only independent predictor for ventricular arrhythmias up to 9 months. At 12 months, a reduced ejection fraction was an additional risk predictor. Conclusions In heart failure patients, the red blood cell fatty acid profile is altered. Omega-3 fatty acids are elevated and predict the risk of ventricular arrhythmias. |
| doi_str_mv | 10.1016/j.ahj.2007.11.045 |
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However, patients with structural heart disease and an implantable cardioverter defibrillator (ICD) showed no effect or even a proarrhythmic response to fish oil supplementation. Animal studies suggest different electrophysiologic effects of circulating and incorporated omega-3 fatty acids. Methods In 102 ICD patients in New York Health Association functional class II or III, the fatty acid composition of red blood cells was analyzed by gas chromatography. The omega-3 index was calculated from eicosapentaenoic acid and docosahexaenoic acid. Patients were followed for 1 year, and ventricular arrhythmias requiring antitachycardic therapy were analyzed. Twenty-five healthy subjects served as control. Results In ICD patients, the fatty acid profile was significantly altered and the baseline omega-3 index was significantly elevated, as compared to control subjects (5.12% ± 0.87% vs 4.24% ± 0.96%, P < .001). Kaplan-Meier estimates of probability of ventricular arrhythmias showed significant differences among quartiles of the omega-3 index. Twelve percent of patients in the lowest quartile had ventricular arrhythmias, as compared to 54% of patients in the highest quartile ( P = .022). In a multivariate analysis, the omega-3 index was the only independent predictor for ventricular arrhythmias up to 9 months. At 12 months, a reduced ejection fraction was an additional risk predictor. Conclusions In heart failure patients, the red blood cell fatty acid profile is altered. Omega-3 fatty acids are elevated and predict the risk of ventricular arrhythmias.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2007.11.045</identifier><identifier>PMID: 18513506</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Arrhythmias, Cardiac - blood ; Arrhythmias, Cardiac - etiology ; Biological and medical sciences ; Blood ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Case-Control Studies ; Defibrillators, Implantable ; Erythrocytes - chemistry ; Fatty acids ; Fatty Acids, Omega-3 - analysis ; Female ; Fish oils ; Heart ; Heart attacks ; Heart Failure - complications ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Male ; Medical sciences ; Middle Aged ; Mortality ; Predictive Value of Tests</subject><ispartof>The American heart journal, 2008-06, Vol.155 (6), p.971-977</ispartof><rights>Mosby, Inc.</rights><rights>2008 Mosby, Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-fdcff51e9f142e0410408c9de16e507a716a9d15ad442d6ffd9abaf45c9096533</citedby><cites>FETCH-LOGICAL-c464t-fdcff51e9f142e0410408c9de16e507a716a9d15ad442d6ffd9abaf45c9096533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504597872?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20400482$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18513506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilhelm, Matthias, MD</creatorcontrib><creatorcontrib>Tobias, Rueth</creatorcontrib><creatorcontrib>Asskali, Fatima, MD</creatorcontrib><creatorcontrib>Kraehner, Robert, MD</creatorcontrib><creatorcontrib>Kuly, Simone, MD</creatorcontrib><creatorcontrib>Klinghammer, Lutz, MD</creatorcontrib><creatorcontrib>Boehles, Hansjosef, MD</creatorcontrib><creatorcontrib>Daniel, Werner Guenther, MD</creatorcontrib><title>Red blood cell omega-3 fatty acids and the risk of ventricular arrhythmias in patients with heart failure</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Epidemiological studies support the protective effect of omega-3 fatty acids on sudden cardiac death. However, patients with structural heart disease and an implantable cardioverter defibrillator (ICD) showed no effect or even a proarrhythmic response to fish oil supplementation. Animal studies suggest different electrophysiologic effects of circulating and incorporated omega-3 fatty acids. Methods In 102 ICD patients in New York Health Association functional class II or III, the fatty acid composition of red blood cells was analyzed by gas chromatography. The omega-3 index was calculated from eicosapentaenoic acid and docosahexaenoic acid. Patients were followed for 1 year, and ventricular arrhythmias requiring antitachycardic therapy were analyzed. Twenty-five healthy subjects served as control. Results In ICD patients, the fatty acid profile was significantly altered and the baseline omega-3 index was significantly elevated, as compared to control subjects (5.12% ± 0.87% vs 4.24% ± 0.96%, P < .001). Kaplan-Meier estimates of probability of ventricular arrhythmias showed significant differences among quartiles of the omega-3 index. Twelve percent of patients in the lowest quartile had ventricular arrhythmias, as compared to 54% of patients in the highest quartile ( P = .022). In a multivariate analysis, the omega-3 index was the only independent predictor for ventricular arrhythmias up to 9 months. At 12 months, a reduced ejection fraction was an additional risk predictor. Conclusions In heart failure patients, the red blood cell fatty acid profile is altered. Omega-3 fatty acids are elevated and predict the risk of ventricular arrhythmias.</description><subject>Adult</subject><subject>Arrhythmias, Cardiac - blood</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Case-Control Studies</subject><subject>Defibrillators, Implantable</subject><subject>Erythrocytes - chemistry</subject><subject>Fatty acids</subject><subject>Fatty Acids, Omega-3 - analysis</subject><subject>Female</subject><subject>Fish oils</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Failure - complications</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Predictive Value of Tests</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kluLFDEQhRtR3HH1B_giAdG3Hqu60zcEQRZvsCB4eQ41ScVOb0_3mKRX5t-bZgYX9sGnEPKdk6pTlWXPEbYIWL8ZttQP2wKg2SJuQVYPsg1C1-R1I-XDbAMARd42UF5kT0IY0rUu2vpxdoFthWUF9SZz39iI3TjPRmgeRzHv-RflpbAU41GQdiYImoyIPQvvwo2YrbjlKXqnl5G8IO_7Y-z3joJwkzhQdOk1iD8u9qJn8jFZuXHx_DR7ZGkM_Ox8XmY_P374cfU5v_766cvV--tcy1rG3BptbYXcWZQFg0SQ0OrOMNZcQUMN1tQZrMhIWZjaWtPRjqysdAddXZXlZfb65Hvw8--FQ1R7F9beaOJ5CSoZYClll8CX98BhXvyUalNYpTC7pm2KROGJ0n4OwbNVB-_25I8KQa1TUINKU1DrFBSiSsKkeXF2XnZ7NneKc-wJeHUGKGgaradJu_CPK1LPINv187cnjlNgt469Cjrlq9k4zzoqM7v_lvHunlqPbnLpwxs-crjrVoVCgfq-rsu6LdACoMSq_AuC5bkG</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Wilhelm, Matthias, MD</creator><creator>Tobias, Rueth</creator><creator>Asskali, Fatima, MD</creator><creator>Kraehner, Robert, MD</creator><creator>Kuly, Simone, MD</creator><creator>Klinghammer, Lutz, MD</creator><creator>Boehles, Hansjosef, MD</creator><creator>Daniel, Werner Guenther, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20080601</creationdate><title>Red blood cell omega-3 fatty acids and the risk of ventricular arrhythmias in patients with heart failure</title><author>Wilhelm, Matthias, MD ; Tobias, Rueth ; Asskali, Fatima, MD ; Kraehner, Robert, MD ; Kuly, Simone, MD ; Klinghammer, Lutz, MD ; Boehles, Hansjosef, MD ; Daniel, Werner Guenther, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-fdcff51e9f142e0410408c9de16e507a716a9d15ad442d6ffd9abaf45c9096533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Arrhythmias, Cardiac - blood</topic><topic>Arrhythmias, Cardiac - etiology</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Case-Control Studies</topic><topic>Defibrillators, Implantable</topic><topic>Erythrocytes - chemistry</topic><topic>Fatty acids</topic><topic>Fatty Acids, Omega-3 - analysis</topic><topic>Female</topic><topic>Fish oils</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Failure - complications</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Predictive Value of Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilhelm, Matthias, MD</creatorcontrib><creatorcontrib>Tobias, Rueth</creatorcontrib><creatorcontrib>Asskali, Fatima, MD</creatorcontrib><creatorcontrib>Kraehner, Robert, MD</creatorcontrib><creatorcontrib>Kuly, Simone, MD</creatorcontrib><creatorcontrib>Klinghammer, Lutz, MD</creatorcontrib><creatorcontrib>Boehles, Hansjosef, MD</creatorcontrib><creatorcontrib>Daniel, Werner Guenther, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilhelm, Matthias, MD</au><au>Tobias, Rueth</au><au>Asskali, Fatima, MD</au><au>Kraehner, Robert, MD</au><au>Kuly, Simone, MD</au><au>Klinghammer, Lutz, MD</au><au>Boehles, Hansjosef, MD</au><au>Daniel, Werner Guenther, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Red blood cell omega-3 fatty acids and the risk of ventricular arrhythmias in patients with heart failure</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>155</volume><issue>6</issue><spage>971</spage><epage>977</epage><pages>971-977</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Epidemiological studies support the protective effect of omega-3 fatty acids on sudden cardiac death. However, patients with structural heart disease and an implantable cardioverter defibrillator (ICD) showed no effect or even a proarrhythmic response to fish oil supplementation. Animal studies suggest different electrophysiologic effects of circulating and incorporated omega-3 fatty acids. Methods In 102 ICD patients in New York Health Association functional class II or III, the fatty acid composition of red blood cells was analyzed by gas chromatography. The omega-3 index was calculated from eicosapentaenoic acid and docosahexaenoic acid. Patients were followed for 1 year, and ventricular arrhythmias requiring antitachycardic therapy were analyzed. Twenty-five healthy subjects served as control. Results In ICD patients, the fatty acid profile was significantly altered and the baseline omega-3 index was significantly elevated, as compared to control subjects (5.12% ± 0.87% vs 4.24% ± 0.96%, P < .001). Kaplan-Meier estimates of probability of ventricular arrhythmias showed significant differences among quartiles of the omega-3 index. Twelve percent of patients in the lowest quartile had ventricular arrhythmias, as compared to 54% of patients in the highest quartile ( P = .022). In a multivariate analysis, the omega-3 index was the only independent predictor for ventricular arrhythmias up to 9 months. At 12 months, a reduced ejection fraction was an additional risk predictor. Conclusions In heart failure patients, the red blood cell fatty acid profile is altered. Omega-3 fatty acids are elevated and predict the risk of ventricular arrhythmias.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>18513506</pmid><doi>10.1016/j.ahj.2007.11.045</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Arrhythmias, Cardiac - blood Arrhythmias, Cardiac - etiology Biological and medical sciences Blood Cardiac arrhythmia Cardiac dysrhythmias Cardiology. Vascular system Cardiovascular Cardiovascular disease Case-Control Studies Defibrillators, Implantable Erythrocytes - chemistry Fatty acids Fatty Acids, Omega-3 - analysis Female Fish oils Heart Heart attacks Heart Failure - complications Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Male Medical sciences Middle Aged Mortality Predictive Value of Tests |
| title | Red blood cell omega-3 fatty acids and the risk of ventricular arrhythmias in patients with heart failure |
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