Fiaccavento Roberta, Carotenuto Felicia, Minieri Marilena, Masuelli Laura, Vecchini Alba, Bei Roberto, Modesti Andrea, Binaglia Luciano, Fusco Angelo, Bertoli Aldo, Forte Giancarlo, Carosella Luciana, Di Nardo Paolo
Laboratorio di Cardiologia Molecolare e Cellulare, Dipartimento di Medicina Interna, Università di Roma Tor Vergata, Via Montpellier, 1, 00133 Roma, Italy.
Am J Pathol. 2006 Dec;169(6):1913-24. doi: 10.2353/ajpath.2006.051320.
Randomized clinical trials have demonstrated that the increased intake of omega-3 polyunsaturated fatty acids significantly reduces the risk of ischemic cardiovascular disease, but no investigations have been performed in hereditary cardiomyopathies with diffusely damaged myocardium. In the present study, delta-sarcoglycan-null cardiomyopathic hamsters were fed from weaning to death with an alpha-linolenic acid (ALA)-enriched versus standard diet. Results demonstrated a great accumulation of ALA and eicosapentaenoic acid and an increased eicosapentaenoic/arachidonic acid ratio in cardiomyopathic hamster hearts, correlating with the preservation of myocardial structure and function. In fact, ALA administration preserved plasmalemma and mitochondrial membrane integrity, thus maintaining proper cell/extracellular matrix contacts and signaling, as well as a normal gene expression profile (myosin heavy chain isoforms, atrial natriuretic peptide, transforming growth factor-beta1) and a limited extension of fibrotic areas within ALA-fed cardiomyopathic hearts. Consequently, hemodynamic indexes were safeguarded, and more than 60% of ALA-fed animals were still alive (mean survival time, 293+/-141.8 days) when all those fed with standard diet were deceased (mean survival time, 175.9+/-56 days). Therefore, the clinically evident beneficial effects of omega-3 polyunsaturated fatty acids are mainly related to preservation of myocardium structure and function and the attenuation of myocardial fibrosis.
随机临床试验表明,增加ω-3多不饱和脂肪酸的摄入量可显著降低缺血性心血管疾病的风险,但尚未对弥漫性心肌损伤的遗传性心肌病进行研究。在本研究中,从断奶到死亡,给δ-肌聚糖缺失的心肌病仓鼠喂食富含α-亚麻酸(ALA)的饮食与标准饮食。结果表明,心肌病仓鼠心脏中ALA和二十碳五烯酸大量积累,二十碳五烯酸/花生四烯酸比值增加,这与心肌结构和功能的保留相关。事实上,给予ALA可保持质膜和线粒体膜的完整性,从而维持适当的细胞/细胞外基质接触和信号传导,以及正常的基因表达谱(肌球蛋白重链异构体、心钠素、转化生长因子-β1),并限制ALA喂养的心肌病心脏内纤维化区域的扩展。因此,血流动力学指标得到保障,当所有喂食标准饮食的动物死亡时(平均存活时间,175.9±56天),超过60%喂食ALA的动物仍然存活(平均存活时间,293±141.8天)。因此,ω-3多不饱和脂肪酸临床上明显的有益作用主要与心肌结构和功能的保留以及心肌纤维化的减轻有关。