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首页> 外文期刊>Vascular pharmacology >Marine omega-3 highly unsaturated fatty acids: From mechanisms to clinical implications in heart failure and arrhythmias
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Marine omega-3 highly unsaturated fatty acids: From mechanisms to clinical implications in heart failure and arrhythmias

机译:海洋omega-3高不饱和脂肪酸:从机制到心力衰竭和心律不齐的临床意义

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Therapeutic implications of marine omega-3 highly unsaturated fatty acids (HUFA) in cardiovascular disease are still discussed controversially. Several clinical trials report divergent findings and thus leave ambiguity on the meaning of oral omega-3 therapy. Potential prognostic indications of HUFA treatment have been predominantly studied in coronary artery disease, sudden cardiac death, ventricular arrhythmias, atrial fibrillation and heart failure of various origin. It is suspected that increased ventricular wall stress is crucially involved in the prognosis of heart failure. Increased wall stress and an unfavorable myocardial remodeling is associated with an increased risk of arrhythmias by stretch-activated membrane ion channels. Integration of HUFA into the microenvironment of cardiomyocyte ion channels lead to allosteric changes and increase the electrical stability. Increased ventricular wall stress appears to be involved in the local myocardial as well as in the hepatic fatty acid metabolism, i.e. a cardio-hepatic syndrome. Influences of an altered endogenous HUFA metabolism and an inverse shift of the fatty acid profile was underrated in the past. A better understanding of these interacting endogenous mechanisms appears to be required for interpreting the findings of recent experimental and clinical studies. The present article critically reviews major studies on basic pathophysiological mechanisms and treatment effects in clinical trials. (C) 2016 Elsevier Inc. All rights reserved.
机译:海洋omega-3高不饱和脂肪酸(HUFA)在心血管疾病中的治疗意义仍存在争议。几项临床试验报告了不同的发现,因此对口服omega-3疗法的含义不明确。 HUFA治疗的潜在预后指标主要研究了冠心病,心源性猝死,室性心律不齐,房颤和各种心力衰竭。怀疑增加的心室壁压力与心力衰竭的预后至关重要。壁应力增加和不利的心肌重塑与拉伸激活的膜离子通道导致心律不齐的风险增加有关。 HUFA整合到心肌细胞离子通道的微环境中会导致变构变化并增加电稳定性。心室壁压力的增加似乎与局部心肌以及肝脂肪酸代谢有关,即心肝综合征。过去低估了内源性HUFA代谢改变和脂肪酸谱逆向变化的影响。解释最近的实验和临床研究结果似乎需要对这些相互作用的内源性机制有更好的了解。本文对临床试验中基本病理生理机制和治疗效果的主要研究进行了严格的评论。 (C)2016 Elsevier Inc.保留所有权利。

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