心力衰竭患者的ω-3 指数：一项前瞻性队列研究。

The omega-3 index in patients with heart failure: A prospective cohort study.

机构信息

Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Hannover Medical School (MHH), Dept. of Cardiology and Angiology, Hannover, Germany.

Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany.

出版信息

Prostaglandins Leukot Essent Fatty Acids. 2019 Jan;140:34-41. doi: 10.1016/j.plefa.2018.11.012. Epub 2018 Nov 28.

DOI:10.1016/j.plefa.2018.11.012

PMID:30553401

Abstract

BACKGROUND

Epidemiologic studies on the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in heart failure are scarce, while one large intervention trial demonstrated a modest benefit.

METHODS

This is a secondary analysis from the Interdisciplinary Network Heart Failure (INH) program. Patients hospitalized for systolic heart failure were enrolled and followed for 36 months. At baseline, whole blood samples from 899 patients were analyzed for fatty acid composition using a standardized analytical procedure (HS-Omega-3 Index®, O3-I). Associations of the O3-I with markers of heart failure severity, clinical characteristics, biomarkers, and mortality were analyzed.

RESULTS

The mean O3-I was 3.7 ± 1.0%. Patient mean age was 68 ± 12 years (72% male, 43% in New York Heart Association (NYHA) class III or IV, mean LVEF 30 ± 8%). During follow-up 258 patients (28.7%) died. After adjustment for potential confounders, the O3-I showed weak associations with uncured malignancy, end-systolic diameter of the left atrium, left ventricular end-diastolic and end-systolic diameters, and blood lipids and other laboratory parameters (all p < 0.05), but not with NYHA class, left ventricular ejection fraction, and the underlying cause of heart failure. The O3-I did not predict the 3-year mortality risk.

CONCLUSIONS

Our results show a marked depletion of omega-3 fatty acids in patients hospitalized for decompensated heart failure (suggested target range 8-11%). Although the O3-I was associated with a panel of established risk indicators in heart failure, it did not predict mortality risk.

CLINICAL TRIAL REGISTRATION

www.controlled-trials.com; ISRCTN23325295.

摘要

背景

关于 ω-3 脂肪酸二十碳五烯酸 (EPA) 和二十二碳六烯酸 (DHA) 在心力衰竭中的流行病学研究很少，而一项大型干预试验表明其具有适度益处。

方法

这是跨学科心力衰竭网络 (INH) 计划的二次分析。因收缩性心力衰竭住院的患者被纳入并随访 36 个月。在基线时，使用标准化分析程序 (HS-Omega-3 Index®，O3-I) 分析了 899 名患者的全血样本中的脂肪酸组成。分析了 O3-I 与心力衰竭严重程度标志物、临床特征、生物标志物和死亡率的关系。

结果

平均 O3-I 为 3.7±1.0%。患者平均年龄为 68±12 岁（72%为男性，43%为纽约心脏协会 (NYHA) 心功能分级 III 或 IV 级，平均左心室射血分数 30±8%）。随访期间 258 名患者（28.7%）死亡。调整潜在混杂因素后，O3-I 与未治愈的恶性肿瘤、左心房收缩末期直径、左心室舒张末期和收缩末期直径以及血脂和其他实验室参数均呈弱相关（均 P<0.05），但与 NYHA 心功能分级、左心室射血分数和心力衰竭的潜在病因无关。O3-I 不能预测 3 年死亡率风险。