Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Eur J Heart Fail. 2010 Dec;12(12):1345-53. doi: 10.1093/eurjhf/hfq172. Epub 2010 Oct 16.
The GISSI-HF trial showed that n-3 polyunsaturated fatty acids (PUFA), but not rosuvastatin, reduce morbidity and mortality in patients with symptomatic heart failure (HF) of any cause. The aim of this echocardiographic substudy of GISSI-HF was to investigate the effects of n-3 PUFA and of rosuvastatin on left ventricular (LV) function in such patients.
Six hundred and eight chronic HF patients were randomized to n-3 PUFA (n=312) or placebo (n=296); a second randomization was performed to rosuvastatin (n=212) or placebo (n=207). Echocardiographic examinations were recorded at baseline and at 1, 2, and 3 years; offline analysis was performed by a core laboratory to ensure consistent quantitative analysis. Baseline LV ejection fraction (EF) was 30% (95%CI 29-31). Left ventricular ejection fraction increased with n-3 PUFA by 8.1% at 1 year, 11.1% at 2 years, and 11.5% at 3 years vs. 6.3% at 1 year, 8.2% at 2 years, and 9.9% at 3 years in the placebo group (P=0.0050). No other echocardiographic parameter changed significantly. Rosuvastatin effects were not statistically significant.
n-3 PUFA can provide a small but statistically significant advantage in terms of LV function in patients with symptomatic HF of any aetiology, already treated with recommended therapies.
GISSI-HF 试验表明，n-3 多不饱和脂肪酸（PUFA）而非瑞舒伐他汀可降低任何病因所致有症状心力衰竭（HF）患者的发病率和死亡率。GISSI-HF 这项超声心动图子研究旨在探讨 n-3 PUFA 和瑞舒伐他汀对这类患者左心室（LV）功能的影响。
608 例慢性 HF 患者随机分为 n-3 PUFA（n=312）或安慰剂（n=296）；第二次随机分为瑞舒伐他汀（n=212）或安慰剂（n=207）。在基线和 1、2、3 年时进行超声心动图检查；由核心实验室进行离线分析，以确保一致的定量分析。基线时 LV 射血分数（EF）为 30%（95%CI 29-31）。与安慰剂组相比，n-3 PUFA 治疗 1 年时 EF 增加 8.1%，2 年时增加 11.1%，3 年时增加 11.5%，而安慰剂组 1 年时增加 6.3%，2 年时增加 8.2%，3 年时增加 9.9%（P=0.0050）。其他超声心动图参数无明显变化。瑞舒伐他汀的作用无统计学意义。
对于已接受推荐疗法治疗的有症状的任何病因 HF 患者，n-3 PUFA 可在 LV 功能方面提供微小但具有统计学意义的优势。
