Cardiovascular Research Advance Access [Accepted Manuscript] published online on May 27, 2009
Cardiovascular Research, 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, MD
3 Department of Nutrition, Case Western Reserve University, Cleveland, OH
Correspondence: William C. Stanley, Ph.D., Professor, Division of Cardiology, Department of Medicine, University of Maryland-Baltimore, 20 Penn Street, HSF2, Room S022, Baltimore, MD 21201, Phone: 410-706-3585, Fax: 410-706-3583, Email: wstanley{at}medicine.umaryland.edu
Heart failure is a complex clinical syndrome with multiple etiologies. Current treatment options can slow the progression to heart failure, 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 heart failure, and that supplementation with pharmacological doses prolongs event-free survival in patients with established heart failure. 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 favorably alters cardiac mitochondrial function. All of these effects may work to prevent the development and progression of heart failure. The -3PUFA found in plant sources, 
-linolenic acid, may also be protective in heart failure; 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 heart failure, and discusses possible mechanisms of action. In general, there is growing evidence that supplementation with -3PUFA positively impacts established pathophysiological targets in heart failure, and has potential therapeutic utility for heart failure patients.
KEYWORDS -linolenic acid; cardiac; docosahexaenoic acid; eicosapentaenoic acid; inflammation; metabolism
Time for primary review: 37 Days