Effects of omega-3 polyunsaturated fatty acids on left ventricular remodeling in chronic heart failure
Omega-3 fatty acids improve aspects of heart failure.
More than 26 million people worldwide currently live with heart failure, a serious condition characterized by diminished capacity of the heart’s ventricles to fill with or eject blood and cardiomyocyte death. Adaptive responses to heart failure induce ventricular remodeling – structural and functional accommodations of the left ventricle that hinder contractility and impair ventricular filling. Findings from a recent systematic review and meta-analysis suggest that omega-3 fatty acids improve aspects of left ventricular remodeling in people with heart failure.
Omega-3 fatty acids are polyunsaturated fats that play critical roles in human health. They exert powerful cardioprotective effects via their participation in pathways involved in blood clotting, arterial contraction and relaxation, inflammation, and many other physiological processes. Omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is found mainly in plant oils such as flaxseed, soybean, and canola oils. DHA and EPA are found in fish and other seafood. The human body can convert some ALA into EPA and then to DHA, but the process is very inefficient.
The reviewers searched the scientific literature for randomized controlled trials investigating the effects of omega-3 fatty acids on left ventricular remodeling in the setting of heart failure. Then they filtered their findings based on a set of criteria designed to identify high-quality studies. Finally, they combined data from these high-quality studies and reanalyzed them so they could interpret the results on a large scale.
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Their analysis identified 11 trials, involving more than 2,000 participants, ranging in age between 51 and 74 years. They found that dosage and duration varied among the trials, ranging from 1.0 to 5.2 grams of total combined EPA and DHA per day, for three to 12 months. Participants who received omega-3 fatty acid supplementation showed marked improvements in left ventricular ejection fraction as well as decreased left ventricular end-systolic volume – two critical measures of heart function. Notably, these improvements were observed only when participants achieved an accumulated dose of 600 grams or more.
These findings suggest that omega-3 fatty acids exert potent cardioprotective effects in a dose- and duration-dependent manner. One of the mechanisms that may drive these effects involves byproducts of omega-3 fatty acid metabolism called specialized pro-resolving mediators. Scientists have identified four families of specialized pro-resolving mediators, including the resolvins, lipoxins, protectins, and maresins. These remarkable and diverse molecules reduce the inflammation that promotes many chronic diseases, including heart failure. Learn more about specialized pro-resolving mediators in this clip featuring Dr. Bill Harris.