Dominik Berliner1, Sarah Mattern2, Mareike Wellige2, Carolin Malsch3, Gülmisal Güder4, Susanne Brenner4, Caroline Morbach4, Nikolas Deubner5, Margret Breunig4, Rosemarie Kiefl6, Christiane E Angermann4, Georg Ertl4, Clemens von Schacky7, Stefan Störk8. 1. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Hannover Medical School (MHH), Dept. of Cardiology and Angiology, Hannover, Germany. 2. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany. 3. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany. 4. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Dept. of Internal Medicine I - Cardiology, University Hospital Würzburg, Germany. 5. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Kerckhoff Clinic, Centre for Heart, Thoracic and Rheumatic Diseases, Bad Nauheim, Germany. 6. Omegametrix, Martinsried, Germany. 7. Omegametrix, Martinsried, Germany; Preventive Cardiology, Medical Clinic I, Ludwig Maximilians-University, Munich, Germany. 8. Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany; Dept. of Internal Medicine I - Cardiology, University Hospital Würzburg, Germany. Electronic address: Stoerk_S@ukw.de.
Abstract
BACKGROUND: Epidemiologic studies on the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in heart failure are scarce, while one large intervention trial demonstrated a modest benefit. METHODS: This is a secondary analysis from the Interdisciplinary Network Heart Failure (INH) program. Patients hospitalized for systolic heart failure were enrolled and followed for 36 months. At baseline, whole blood samples from 899 patients were analyzed for fatty acid composition using a standardized analytical procedure (HS-Omega-3 Index®, O3-I). Associations of the O3-I with markers of heart failure severity, clinical characteristics, biomarkers, and mortality were analyzed. RESULTS: The mean O3-I was 3.7 ± 1.0%. Patient mean age was 68 ± 12 years (72% male, 43% in New York Heart Association (NYHA) class III or IV, mean LVEF 30 ± 8%). During follow-up 258 patients (28.7%) died. After adjustment for potential confounders, the O3-I showed weak associations with uncured malignancy, end-systolic diameter of the left atrium, left ventricular end-diastolic and end-systolic diameters, and blood lipids and other laboratory parameters (all p < 0.05), but not with NYHA class, left ventricular ejection fraction, and the underlying cause of heart failure. The O3-I did not predict the 3-year mortality risk. CONCLUSIONS: Our results show a marked depletion of omega-3 fatty acids in patients hospitalized for decompensated heart failure (suggested target range 8-11%). Although the O3-I was associated with a panel of established risk indicators in heart failure, it did not predict mortality risk. CLINICAL TRIAL REGISTRATION: www.controlled-trials.com; ISRCTN23325295.
RCT Entities:
BACKGROUND: Epidemiologic studies on the omega-3 fatty acidseicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in heart failure are scarce, while one large intervention trial demonstrated a modest benefit. METHODS: This is a secondary analysis from the Interdisciplinary Network Heart Failure (INH) program. Patients hospitalized for systolic heart failure were enrolled and followed for 36 months. At baseline, whole blood samples from 899 patients were analyzed for fatty acid composition using a standardized analytical procedure (HS-Omega-3 Index®, O3-I). Associations of the O3-I with markers of heart failure severity, clinical characteristics, biomarkers, and mortality were analyzed. RESULTS: The mean O3-I was 3.7 ± 1.0%. Patient mean age was 68 ± 12 years (72% male, 43% in New York Heart Association (NYHA) class III or IV, mean LVEF 30 ± 8%). During follow-up 258 patients (28.7%) died. After adjustment for potential confounders, the O3-I showed weak associations with uncured malignancy, end-systolic diameter of the left atrium, left ventricular end-diastolic and end-systolic diameters, and blood lipids and other laboratory parameters (all p < 0.05), but not with NYHA class, left ventricular ejection fraction, and the underlying cause of heart failure. The O3-I did not predict the 3-year mortality risk. CONCLUSIONS: Our results show a marked depletion of omega-3 fatty acids in patients hospitalized for decompensated heart failure (suggested target range 8-11%). Although the O3-I was associated with a panel of established risk indicators in heart failure, it did not predict mortality risk. CLINICAL TRIAL REGISTRATION: www.controlled-trials.com; ISRCTN23325295.