Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Heart Rhythm. 2012 Jul;9(7):1115-1122.e4. doi: 10.1016/j.hrthm.2012.02.013. Epub 2012 Feb 15.
Prophylactic supplementation with omega-3 polyunsaturated fatty acids (PUFAs) reduce vulnerability to atrial fibrillation (AF). The effect of PUFAs given after cardiac injury has occurred is unknown.
To investigate using a model of pacing-induced cardiac injury, the time course of development of injury and whether it was altered by postinjury PUFAs.
Sixty-five dogs were randomized to undergo simultaneous atrial and ventricular pacing (SAVP, 220 beats/min) for 0, 2, 7, or 14 days. Twenty-two dogs received PUFAs (850 mg/d) either prophylactically or after some pacing had occurred (postinjury). Electrophysiologic and echocardiographic measurements were taken at baseline and sacrifice. Atrial tissue samples were collected at sacrifice for histologic and molecular analyses.
With no PUFAs, the inducibility of AF increased with pacing duration (P < .001). Postinjury PUFAs (started after 7 days of pacing) did not reduce the inducibility of AF after 14 days of pacing (9.3% ± 8.8% no PUFAs vs 9.7% ± 9.9% postinjury PUFAs; P = .91). Atrial myocyte size and fibrosis increased with pacing duration (P < .05). Postinjury PUFAs did not significantly attenuate the cell size increase after 14 days of pacing (no PUFAs 38% ± 30% vs postinjury PUFAs 19% ± 28%; P = .11). Similarly, postinjury PUFAs did not attenuate the increase in fibrosis after 14 days of pacing (no PUFAs 66% ± 51% vs postinjury PUFAs 63% ± 76%; P = .90).
PUFA supplementation begun after cardiac injury has already occurred does not reduce atrial structural remodeling or vulnerability to AF.
预防性补充ω-3 多不饱和脂肪酸(PUFAs)可降低心房颤动(AF)的易感性。在心脏损伤后给予 PUFAs 的效果尚不清楚。
通过起搏诱导的心脏损伤模型,研究损伤的发展过程及其是否因损伤后 PUFAs 的作用而改变。
将 65 只狗随机分为两组,同时进行心房和心室起搏(SAVP,220 次/分)0、2、7 或 14 天。22 只狗预防性或在某些起搏后(损伤后)给予 PUFAs(850mg/d)。在基线和牺牲时进行电生理和超声心动图测量。牺牲时收集心房组织样本进行组织学和分子分析。
在没有 PUFAs 的情况下,AF 的诱发性随着起搏时间的延长而增加(P<0.001)。损伤后 PUFAs(在起搏 7 天后开始)并没有降低 14 天起搏后的 AF 诱发性(无 PUFAs 9.3%±8.8%vs 损伤后 PUFAs 9.7%±9.9%;P=0.91)。心房肌细胞大小和纤维化随起搏时间延长而增加(P<0.05)。损伤后 PUFAs 并没有显著减轻起搏 14 天后细胞大小的增加(无 PUFAs 38%±30%vs 损伤后 PUFAs 19%±28%;P=0.11)。同样,损伤后 PUFAs 也没有减轻起搏 14 天后纤维化的增加(无 PUFAs 66%±51%vs 损伤后 PUFAs 63%±76%;P=0.90)。
在心脏损伤已经发生后开始补充 PUFAs 并不能减少心房结构重塑或对 AF 的易感性。