Cardiovascular Research Advance Access originally published online on May 27, 2009
Cardiovascular Research 2009 84(1):33-41; doi:10.1093/cvr/cvp169
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-3 polyunsaturated fatty acid supplementation for the treatment of heart failure: mechanisms and clinical potential
1 Department of Clinical Physiology, Medical Centre of Postgraduate Education, Warsaw, Poland
2 Division of Cardiology, Department of Medicine, University of Maryland-Baltimore, 20 Penn Street, HSF2, Room S022 Baltimore, MD 21201, USA
3 Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
* Corresponding author. Tel: +1 410 706 3585; fax: +1 410 706 3583. E-mail address: wstanley{at}medicine.umaryland.edu
Heart failure (HF) is a complex clinical syndrome with multiple aetiologies. Current treatment options can slow the progression to HF, but overall the prognosis remains poor. Clinical studies suggest that high dietary intake of the 
-3 polyunsaturated fatty acids (-3PUFA) found in fish oils (eicosapentaenoic and docosahexaenoic acids) may lower the incidence of HF, and that supplementation with pharmacological doses prolongs event-free survival in patients with established HF. The mechanisms for these potential benefits are complex and not well defined. It is well established that fish oil supplementation lowers plasma triglyceride levels, and more recent work demonstrates anti-inflammatory effects, including reduced circulating levels of inflammatory cytokines and arachidonic acid-derived eicosanoids, and elevated plasma adiponectin. In animal studies, fish oil favourably alters cardiac mitochondrial function. All of these effects may work to prevent the development and progression of HF. The -3PUFA found in plant sources, 
-linolenic acid, may also be protective in HF; however, the evidence is not as compelling as for fish oil. This review summarizes the evidence related to use of -3PUFA supplementation as a potential treatment for HF and discusses possible mechanisms of action. In general, there is growing evidence that supplementation with -3PUFA positively impacts established pathophysiological targets in HF and has potential therapeutic utility for HF patients.
KEYWORDS -Linolenic acid; Cardiac; Docosahexaenoic acid; Eicosapentaenoic acid; Inflammation; Metabolism
Time for primary review: 37 days