Marine n-3 PUFA, heart rate variability and ventricular arrhythmias in patients on chronic dialysis: a cross-sectional study

Abstract

Marine n-3 PUFA may improve autonomic dysfunction by an increase in heart rate variability (HRV) and may reduce the risk of malignant ventricular arrhythmias. Only a few smaller studies have examined such effects in patients on chronic dialysis, who often have autonomic dysfunction and a high risk of sudden cardiac death, which accounts for almost 30 % of all deaths. This cross-sectional study investigated the association between the plasma phospholipid content of n-3 PUFA and 24-h HRV or ventricular arrhythmias in patients on chronic dialysis. A 48-h Holter monitoring was performed on 169 patients on in-centre dialysis (83 %), home haemodialysis (10 %) or peritoneal dialysis (7 %) obtaining data on arrhythmias (n 152) and 24-h HRV (n 135). The mean overall HRV (standard deviation of normal intervals (SDNN)) was low and 71 % had a reduced overall HRV (SDNN<100 ms) indicating autonomic dysfunction. No significant associations between plasma phospholipid content of total marine n-3 PUFA, EPA (22 : 5n-3) or DHA (22 : 6n-3) and time-domain or frequency-domain HRV were detected in crude or adjusted linear regression analysis. However, a higher plasma phospholipid content of DHA was associated with a significantly lower proportion of patients with ventricular tachycardia (higher DHA-tertile: 9 % v. lower DHA-tertile: 28 %, P=0·02). In conclusion, the content of marine n-3 PUFA in plasma phospholipids was not associated with 24-h HRV, but a higher plasma phospholipid content of DHA was associated with a lower occurrence of ventricular tachycardia suggesting an antiarrhythmic effect of marine n-3 PUFA in patients on chronic dialysis.

Effects of parathyroidectomy on plasma PTH fragments and heart rate variability in stage 5 chronic kidney disease patients

“…The HRV is an effective method to evaluate cardiac autonomic nervous function and has an independent prognostic value in chronic hemodialysis patients with increased risks for all-cause and sudden death [ 32 ]. The decreased HRV indices in ESKD patients reflect the impairment of the autonomic nervous regulation on the cardiovascular system, and is an independent predictor of cardiac death [ 8 ].…”

“…Heart rate variability (HRV) is a noninvasive measurement to evaluate autonomic dysfunction that reflects beat-to-beat variability in the heart rate. A decrease in the HRV has an independent predictive value for the occurrence of various CVDs, especially ventricular arrhythmias and sudden cardiac death [ 8–10 ]. Our previous study proved that HRV indices decreased significantly in CKD5 patients, especially in patients with severe SHPT, while PTX could improve the reduced HRV parameters [ 11 , 12 ].…”

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

“…Svensson et al [ 29 ] randomized 43 HD patients to 1.7 g marine n -3 PUFA or control for three months with no effect observed of n -3 PUFA on 24-h time-domain HRV. A recently published cross sectional study from our center also failed to show associations between plasma phospholipid content of marine n -3 PUFA and time- and frequency domain HRV in 135 dialysis patients [ 30 ]. The present study is the largest study investigating the effects of marine n -3 PUFA supplements on autonomic function in patients on chronic dialysis.…”

Heart Rate Variability and Long Chain n-3 Polyunsaturated Fatty Acids in Chronic Kidney Disease Patients on Haemodialysis: A Cross-Sectional Pilot Study

“…Svensson et al measured LC n -3 PUFA in serum phospholipids in 30 patients and found no correlations with 24 h HRV measurements at baseline [ 18 ]. Rantanen et al measured LC n -3 PUFA in plasma phospholipids in 135 patients and found no significant associations with 24 h time-domain or frequency-domain HRV [ 34 ].…”