Effects of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability and Heart Rate in Patients on Chronic Dialysis: A Randomized Controlled Trial

Abstract

Marine n-3 polyunsaturated fatty acids (PUFA) may improve autonomic dysfunction, as indicated by an increase in heart rate variability (HRV) and reduce the risk of sudden cardiac death. Hence, the aim of this study was to investigate the effects of marine n-3 PUFA on 24-h HRV in patients on chronic dialysis, who have a high risk of sudden cardiac death. Between June 2014 and March 2016, 112 patients on chronic dialysis from Denmark were allocated to a daily supplement of 2 g marine n-3 PUFA or control for three months in a randomized, double-blinded, controlled trial. A 48-h Holter monitoring was performed and mean 24-h HRV indices for the two days were available in 85 patients. The mean age was 62.3 years (SD: 14.3) and median dialysis vintage was 1.7 years (IQR: 0.5, 6.4). Within-group and between-group changes in outcome were evaluated by a paired and two sample t-test, respectively. Marine n-3 PUFA did not change the primary endpoint SDNN (SD of all RR-intervals) reflecting overall HRV, but other HRV indices increased and the mean RR-interval increased significantly, corresponding to a decrease in heart rate by 2.5 beats per minute (p = 0.04). In conclusion, marine n-3 PUFA did not change SDNN, but the mean heart rate was significantly reduced and changes in other HRV-indices were also observed, indicating an increase in vagal modulation that might be protective against malignant ventricular arrhythmias.

The Effect of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability in Renal Transplant Recipients: A Randomized Controlled Trial

“…Another meta-analysis showed a significantly reduced rHR after supplementation with marine n-3 PUFA, with a mean reduction of 2.2 bpm overall and a more pronounced effect from DHA than EPA [45]. In a recent RCT of patients treated with chronic HD, a similar reduction in rHR (2.5 bpm) was shown after treatment with 2 g of marine n-3 PUFA for 12 weeks [34].…”

“…[8,33]. In the largest study to date, Rantanen et al randomized 112 HD patients to 2 g of marine n-3 PUFA or control for 12 weeks and showed an improvement in HRV parameters reflecting vagal tone and a significant reduction in rHR, but no significant effect on the primary endpoint, SDNN [34]. There are, however, multiple factors that may affect HRV in patients with CKD, including frequent use of medications.…”

Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

“…After the exclusion of 437 duplications, 1051 references were reviewed for eligibility. Then, two systematic reviews and 25 randomized clinical trials without relevant outcomes were excluded [31,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69]. There were 21 references from 18 RCTs meeting the eligibility criteria (Figure 1) [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30].…”

Potential Cardiovascular and Metabolic Beneficial Effects of ω-3 PUFA in Male Obesity Secondary Hypogonadism Syndrome

“…ω-3 PUFA supplementation was also associated with the reduction of heart rate at rest [73,74], the reduction of systolic and diastolic blood [75,76], and the increase in early and late left ventricular ejection fraction [77].…”