Radaelli Alberto, Cazzaniga Maria, Viola Andrea, Balestri Giulia, Janetti Maria Bianchi, Signorini Maria G, Castiglioni Paolo, Azzellino Arianna, Mancia Giuseppe, Ferrari Alberto U
Divisione di Riabilitazione Cardiologica, Ospedale San Gerardo, Monza, Italy.
J Am Coll Cardiol. 2006 Oct 17;48(8):1600-6. doi: 10.1016/j.jacc.2006.05.073. Epub 2006 Sep 26.
The intention of this study was to test the hypothesis that, in heart failure patients, dietary supplementation of polyunsaturated fatty acids (PUFA) enhances arterial baroreceptor control of the cardiovascular system.
Administration of PUFA reduces the risk of life-threatening arrhythmias in patients surviving myocardial infarction. This might result from potentiation of arterial baroreflexes, but whether or not PUFA enhance baroreflex function has never been studied in humans.
Patients with post-myocardial infarction left ventricular dysfunction underwent beat-to-beat blood pressure (BP) (Finapres, Ohmeda Inc., Englewood, Colorado) and R-R interval (electrocardiogram) recording; baroreceptor reflexes were assessed from the bradycardic and depressor responses to graded neck suction (NS) as well as by computation of the alpha "spontaneous" baroreflex sensitivity index. Assessments were repeated after prolonged treatment with PUFA (2 g/die, n = 15) or placebo (n = 10).
Baseline BP and R-R interval were unaffected by PUFA. Both reflex depressor and bradycardic responses to NS increased after PUFA (respectively from -0.09 +/- 0.01 to -0.16 +/- 0.01 mm Hg x mm Hg(-1), p < 0.01, and from 1.25 +/- 0.9 to 1.76 +/- 1.1 ms x mm Hg(-1), p < 0.04) but not after placebo. The spontaneous baroreflex sensitivity increased in the PUFA (from 8.99 +/- 1.4 to 12.2 +/- 1.2 ms x mm Hg(-1), p < 0.02) but not in the placebo group. Polyunsaturated fatty acids (but not placebo) treatment also significantly increased R-R interval total variance and low-frequency and high-frequency spectral powers.
Dietary PUFA supplementation markedly potentiates baroreflex function and enhances heart rate variability in patients with stable congestive heart failure.
本研究旨在验证以下假设：在心力衰竭患者中，饮食中补充多不饱和脂肪酸（PUFA）可增强动脉压力感受器对心血管系统的控制。
给予PUFA可降低心肌梗死存活患者发生危及生命的心律失常的风险。这可能是由于动脉压力反射增强所致，但PUFA是否能增强压力反射功能在人类中尚未得到研究。
对心肌梗死后左心室功能不全的患者进行逐搏血压（BP）（Finapres，Ohmeda公司，科罗拉多州恩格尔伍德）和R-R间期（心电图）记录；通过对分级颈部负压吸引（NS）的心动过缓和降压反应以及计算α“自发”压力反射敏感性指数来评估压力感受器反射。在用PUFA（2克/天，n = 15）或安慰剂（n = 10）进行长期治疗后重复评估。
基线血压和R-R间期不受PUFA影响。PUFA治疗后，对NS的反射性降压和心动过缓反应均增加（分别从-0.09±0.01至-0.16±0.01 mmHg×mmHg-1，p < 0.01，以及从1.25±0.9至1.76±1.1 ms×mmHg-1，p < 0.04），而安慰剂治疗后无此变化。PUFA组的自发压力反射敏感性增加（从8.99±1.4至12.2±1.2 ms×mmHg-1，p < 0.02），而安慰剂组未增加。多不饱和脂肪酸（而非安慰剂）治疗还显著增加了R-R间期的总方差以及低频和高频谱功率。
饮食中补充PUFA可显著增强稳定型充血性心力衰竭患者的压力反射功能并提高心率变异性。
