Mozaffarian Dariush
Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
J Cardiovasc Med (Hagerstown). 2007 Sep;8 Suppl 1:S23-6. doi: 10.2459/01.JCM.0000289279.95427.e2.
Consistent evidence indicates that modest consumption of fish or fish oil supplementation lowers the incidence of cardiac death and possibly other cardiovascular events. Precise physiologic mechanisms accounting for such reduced clinical risk are not well understood. Animal-experimental studies, randomized trials, and large observational studies indicate that consumption of fish and marine n-3 polyunsaturated fatty acids (PUFAs) affects cardiac haemodynamics. Independent effects include lowering of systemic vascular resistance (reducing systolic blood pressure by approximately 3-5 mmHg and diastolic blood pressure by approximately 2-3 mmHg); reduction of resting heart rate (by approximately 3 bpm); and improvement of cardiac diastolic filling (by means of potential improvement in both active relaxation and passive compliance). Stroke volume increases, apparently a secondary effect of lower vascular resistance, slower heart rate, and improved filling; direct effects on resting contractility or cardiac output are not evident. These haemodynamic effects could in part account for clinical benefits of fish or fish oil intake, including lower risk of cardiac death and possibly ischaemic stroke, heart failure, cognitive decline, and nonfatal coronary events.
一致的证据表明，适度食用鱼类或补充鱼油可降低心脏性死亡的发生率，并可能降低其他心血管事件的发生率。导致临床风险降低的确切生理机制尚不完全清楚。动物实验研究、随机试验和大型观察性研究表明，食用鱼类和海洋n-3多不饱和脂肪酸（PUFA）会影响心脏血流动力学。独立作用包括降低全身血管阻力（收缩压降低约3-5 mmHg，舒张压降低约2-3 mmHg）；降低静息心率（约3次/分钟）；改善心脏舒张期充盈（通过潜在改善主动舒张和被动顺应性）。每搏输出量增加，这显然是血管阻力降低、心率减慢和充盈改善的次要效应；对静息收缩力或心输出量无明显直接影响。这些血流动力学效应可能部分解释了摄入鱼类或鱼油的临床益处，包括降低心脏性死亡风险以及可能降低缺血性中风、心力衰竭、认知衰退和非致命性冠状动脉事件的风险。
