Clinical Prevention of Sudden Cardiac Death by n-3 Polyunsaturated Fatty Acids and Mechanism of Prevention of Arrhythmias by n-3 Fish Oils

Leaf, Alexander; Kang, Jing; Xiao, Yong‐Fu; Billman, George E.

doi:10.1161/01.cir.0000069566.78305.33

Cited by 539 publications

(373 citation statements)

References 32 publications

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“…The anti-arrhythmic effects of n-3 fatty acids are due to their ability to inhibit the fast, voltage-dependent sodium current and the L-type calcium currents, and also to modulate potassium channels (51) .…”

Section: Possible Mechanismsmentioning

confidence: 99%

Dietary n-3 PUFA and CVD: a review of the evidence

Mori

2013

Proc. Nutr. Soc.

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Many clinical and epidemiological studies have shown that the polyunsaturated n-3 fatty acids EPA and DHA from fish and fish oils, provide cardiovascular protection, particularly in the setting of secondary prevention. n-3 Fatty acids beneficially influence a number of cardiometabolic risk factors including blood pressure, cardiac function, vascular reactivity and lipids, as well as having anti-platelet, anti-inflammatory and anti-oxidative actions. They do not appear to adversely interact with other medications such as statins and other lipid-lowering drugs or antihypertensive medications. n-3 Fatty acids have gained widespread usage by general practitioners and clinicians in a number of clinical settings such as pregnancy and infant development, secondary prevention in CHD patients, treatment of dyslipidaemias and haemodialysis patients. Small doses are achievable with consumption of two to three oily fish meals per week or via purified encapsulated preparations now readily available. n-3 Fatty acids, particularly when consumed as fish, should be considered an important component of a healthy diet. The present paper reviews the effects of n-3 fatty acids on cardiometabolic risk factors, concentrating particularly on the evidence from randomised controlled studies in human subjects.

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Section: Possible Mechanismsmentioning

confidence: 99%

Dietary n-3 PUFA and CVD: a review of the evidence

Mori

2013

Proc. Nutr. Soc.

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“…These molecules powerfully influence cellular metabolism. PLA 2 -liberated omega-3 FA may directly modify the activity of ion channel themselves, resulting in altered resting membrane potentials [25]. Finally, intracellular omega-3 FA are also able to serve as ligands for a variety of nuclear receptors [e.g., peroxisome proliferation activated receptors (PPARs), sterol receptor element binding protein (SREBP)-1c, retinoid X receptor, farnesol X receptor, and hepatocyte nuclear factor-α [26,27]] which impact inflammatory responses and lipid metabolism.…”

Section: Omega-3 Mechanismsmentioning

confidence: 99%

“…A relationship between membrane EPA +DHA levels and risk for sudden cardiac death is biologically plausible. Currently, the most likely mechanism by which they appear to operate is via a reduction in myocardial susceptibility to lethal arrhythmias [25,38]. In addition, EPA+DHA may enhance plaque stability [28], and may be anti-atherosclerotic [39,40] via a variety of other mechanisms [1].…”

Section: From Biomarker To Risk Factormentioning

confidence: 99%

Omega-3 fatty acids and cardiovascular disease: A case for omega-3 index as a new risk factor

Harris

2007

Pharmacological Research

233

140

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The omega-3 fatty acids (FAs) found in fish and fish oils (eicosapentaenoic and docosahexaenoic acids, EPA and DHA) have been reported to have a variety of beneficial effects in cardiovascular diseases. Ecological and prospective cohort studies as well as randomized, controlled trials have supported the view that the effects of these FAs are clinically-relevant. They operate via several mechanisms, all beginning with the incorporation of EPA and DHA into cell membranes. From here, these omega-3 FA alter membrane physical characteristics and the activity of membrane-bound proteins, and once released by intracellular phospholipases, can interact with ion channels, be converted into a wide variety of bioactive eicosanoids, and serve as ligands for several nuclear transcription factors thereby altering gene expression. In as much as blood levels are a strong reflection of dietary intake, it is proposed that an omega-3 FA biomarker, the omega-3 index (erythrocyte EPA+DHA) be considered at least a marker, if not a risk factor, for coronary heart disease, especially sudden cardiac death. The omega-3 index fulfils many of the requirements for a risk factor including consistent epidemiological evidence, a plausible mechanism of action, a reproducible assay, independence from classical risk factors, modifiability, and most importantly, the demonstration that raising tissue levels will reduce risk for cardiac events. For these and a number of other reasons, the omega-3 index compares very favourably with other risk factors for sudden cardiac death.

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“…Available evidence suggests that the cardioprotective mechanism of n-3 FAs depends on their presence in myocardial cell membranes (27). Thus one may suggest that an incorporation of EPA and DHA into graft cell membranes might play a role in better graft function and survival in the fish oil-treated animals.…”

Section: Discussionmentioning

confidence: 99%