Omega-3 fatty acid blood levels are inversely associated with cardiometabolic risk factors in HFpEF patients: the Aldo-DHF randomized controlled trial,Clinical Research in Cardiology

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Omega-3 fatty acid blood levels are inversely associated with cardiometabolic risk factors in HFpEF patients: the Aldo-DHF randomized controlled trial
Clinical Research in Cardiology ( IF 3.8 ) Pub Date : 2021-08-28 , DOI: 10.1007/s00392-021-01925-9
Katharina Lechner _{1,

2,

3} , Johannes Scherr _{1,

4} , Martin Halle _{1,

2} , André Duvinage _{1,

2} , Elke Lorenz ₃ , Benjamin Lechner ₅ , Bernhard Haller ₆ , Alexander Krannich ₇ , Rolf Wachter _{8,

9} , Frank Edelmann ₁₀

Affiliation

Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
Kardiologie, Deutsches Herzzentrum München, Munich, Germany
University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
Department of Internal Medicine IV, Ludwig-Maximilians University, Munich, Germany
Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
Charité, Universitätsmedizin Berlin, Berlin, Germany
Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Göttingen, Germany
Department of Cardiology, Campus Virchow Klinikum (CVK), Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

Objectives

To evaluate associations of omega-3 fatty acid (O3-FA) blood levels with cardiometabolic risk markers, functional capacity and cardiac function/morphology in patients with heart failure with preserved ejection fraction (HFpEF).

Background

O3-FA have been linked to reduced risk for HF and associated phenotypic traits in experimental/clinical studies.

Methods

This is a cross-sectional analysis of data from the Aldo-DHF-RCT. From 422 patients, the omega-3-index (O3I = EPA + DHA) was analyzed at baseline in n = 404 using the HS-Omega-3-Index^® methodology. Patient characteristics were; 67 ± 8 years, 53% female, NYHA II/III (87/13%), ejection fraction ≥ 50%, E/e′ 7.1 ± 1.5; median NT-proBNP 158 ng/L (IQR 82–298). Pearson’s correlation coefficient and multiple linear regression analyses, using sex and age as covariates, were used to describe associations of the O3I with metabolic phenotype, functional capacity, echocardiographic markers for LVDF, and neurohumoral activation at baseline/12 months.

Results

The O3I was below (< 8%), within (8–11%), and higher (> 11%) than the target range in 374 (93%), 29 (7%), and 1 (0.2%) patients, respectively. Mean O3I was 5.7 ± 1.7%. The O3I was inversely associated with HbA1c (r = − 0.139, p = 0.006), triglycerides-to-HDL-C ratio (r = − 0.12, p = 0.017), triglycerides (r = − 0.117, p = 0.02), non-HDL-C (r = − 0.101, p = 0.044), body-mass-index (r = − 0.149, p = 0.003), waist circumference (r = − 0.121, p = 0.015), waist-to-height ratio (r = − 0.141, p = 0.005), and positively associated with submaximal aerobic capacity (r = 0.113, p = 0.023) and LVEF (r = 0.211, p < 0.001) at baseline. Higher O3I at baseline was predictive of submaximal aerobic capacity (β = 15.614, p < 0,001), maximal aerobic capacity (β = 0.399, p = 0.005) and LVEF (β = 0.698, p = 0.007) at 12 months.

Conclusions

Higher O3I was associated with a more favorable cardiometabolic risk profile and predictive of higher submaximal/maximal aerobic capacity and lower BMI/truncal adiposity in HFpEF patients.

Graphic abstract

Omega-3 fatty acid blood levels are inversely associated with cardiometabolic risk factors in HFpEF patients. Higher O3I was associated with a more favorable cardiometabolic risk profile and aerobic capacity (left) but did not correlate with echocardiographic markers for left ventricular diastolic function or neurohumoral activation (right). An O3I-driven intervention trial might be warranted to answer the question whether O3-FA in therapeutic doses (with the target O3I 8–11%) impact on echocardiographic markers for left ventricular diastolic function and neurohumoral activation in patients with HFpEF. This figure contains modified images from Servier Medical Art (https://smart.servier.com) licensed by a Creative Commons Attribution 3.0 Unported License.

中文翻译：

Omega-3 脂肪酸血液水平与 HFpEF 患者的心脏代谢危险因素呈负相关：Aldo-DHF 随机对照试验

目标

在射血分数保留的心力衰竭 (HFpEF) 患者中，评估 omega-3 脂肪酸 (O3-FA) 血液水平与心脏代谢风险标志物、功能能力和心脏功能/形态学的关联。

背景

在实验/临床研究中，O3-FA 与降低 HF 风险和相关表型特征有关。

方法

这是对 Aldo-DHF-RCT 数据的横断面分析。使用 HS-Omega-3-Index ^®方法学分析了 422 名患者的 omega-3 指数（O3I = EPA + DHA）在基线时n = 404 。患者特征是；67±8岁，53％为女性，NYHA II / III（87/13％），射血分数≥50％，ê / é “7.1±1.5; NT-proBNP 中位数为 158 ng/L (IQR 82–298)。Pearson 相关系数和多元线性回归分析，使用性别和年龄作为协变量，用于描述 O3I 与代谢表型、功能能力、LVDF 的超声心动图标志物和基线/12 个月时神经体液激活的关联。

结果

374 名 (93%)、29 名 (7%) 和 1 名 (0.2%) 患者的 O3I 低于 (< 8%)、在 (8–11%) 以内和高于 (> 11%) 目标范围，分别。平均 O3I 为 5.7 ± 1.7%。O3I 与 HbA1c（r = - 0.139，p = 0.006）、甘油三酯与 HDL-C 的比率（r = - 0.12，p = 0.017）、甘油三酯（r = - 0.117，p = 0.02）、非-HDL-C ( r = − 0.101, p = 0.044), 体重指数 ( r = − 0.149, p = 0.003), 腰围 ( r = − 0.121, p = 0.015), 腰高比( r = − 0.141, p = 0.005)，并且与基线时的次最大有氧能力 ( r = 0.113, p = 0.023) 和 LVEF ( r = 0.211, p < 0.001)呈正相关。基线时较高的 O3I 可预测 12 个月时的次最大有氧能力（β = 15.614，p < 0,001 ）、最大有氧能力（β = 0.399，p = 0.005）和 LVEF（β = 0.698，p = 0.007）。

结论

较高的 O3I 与更有利的心脏代谢风险特征相关，并预示着 HFpEF 患者的次最大/最大有氧能力和较低的 BMI/躯干肥胖。

图形摘要

在 HFpEF 患者中，Omega-3 脂肪酸血液水平与心脏代谢危险因素呈负相关。较高的 O3I 与更有利的心脏代谢风险特征和有氧能力（左）相关，但与左心室舒张功能或神经体液激活的超声心动图标志物无关（右）。一项 O3I 驱动的干预试验可能有必要回答治疗剂量的 O3-FA（目标 O3I 为 8-11%）是否会影响 HFpEF 患者左心室舒张功能和神经体液激活的超声心动图标志物。此图包含来自 Servier Medical Art (https://smart.servier.com) 的修改图像，该图像由知识共享署名 3.0 未移植许可证许可。

更新日期：2021-08-29

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