Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
J Intern Med. 2011 Sep;270(3):263-72. doi: 10.1111/j.1365-2796.2011.02384.x. Epub 2011 May 3.
Free fatty acids (FFAs) are the major energy sources of the heart, and fatty acids (FAs) are active components of biological membranes. Data indicate that levels of FAs and their composition may influence myocardial function and inflammation. The aim of this study was to investigate whether total levels and composition of FAs and FFAs in plasma are altered in clinical heart failure (HF) and whether any alterations in these parameters are correlated with the severity of HF.
Plasma from 183 patients with stable HF was compared with plasma from 44 healthy control subjects.
Our main findings are as follows: (i) patients with HF had decreased levels of several lipid parameters and increased levels of FFAs in plasma, compared with controls, which were significantly correlated with clinical disease severity. (ii) Patients with HF also had a decreased proportion in the plasma of several n-3 polyunsaturated FAs, an increased proportion of several monounsaturated FAs, and a decreased proportion of some readily oxidized long-chain saturated FAs. (iii) These changes in FA composition were significantly associated with functional class, impaired cardiac function (i.e., decreased cardiac index and increased plasma N-terminal pro-B-type natriuretic peptide levels) and enhanced systemic inflammation (i.e., increased high-sensitivity C-reactive protein levels). (iv) Low levels of C20:4n-3 (eicosatetraenoic acid) and in particular high levels of C18:1n-7 (vaccenic acid) were significantly associated with total mortality in this HF population.
Our data demonstrate that patients with HF are characterized by a certain FA phenotype and may support a link between disturbed FA composition and the progression of HF.
游离脂肪酸（FFAs）是心脏的主要能量来源，脂肪酸（FAs）是生物膜的活性成分。有数据表明，FAs 的水平及其组成可能会影响心肌功能和炎症。本研究旨在探究血浆中 FAs 和 FFAs 的总水平和组成是否在临床心力衰竭（HF）中发生改变，以及这些参数的任何改变是否与 HF 的严重程度相关。
将 183 例稳定型 HF 患者的血浆与 44 例健康对照者的血浆进行比较。
我们的主要发现如下：（i）与对照组相比，HF 患者的几种脂质参数水平降低，血浆中 FFAs 水平升高，且这些参数与临床疾病严重程度显著相关。（ii）HF 患者的血浆中几种 n-3 多不饱和脂肪酸比例降低，几种单不饱和脂肪酸比例升高，一些易氧化的长链饱和脂肪酸比例降低。（iii）FA 组成的这些变化与功能分级、心脏功能受损（即心指数降低和血浆 N 末端 B 型利钠肽前体水平升高）和全身炎症增强（即高敏 C 反应蛋白水平升高）显著相关。（iv）C20:4n-3（二十碳四烯酸）水平低，特别是 C18:1n-7（反油酸）水平高，与 HF 患者的总死亡率显著相关。
我们的数据表明，HF 患者具有特定的 FA 表型，这可能支持 FA 组成紊乱与 HF 进展之间存在关联。
