2013


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2013/№4

Regression of structural and functional rearrangements in heart and kidneys of patients with chronic heart failure in combination with permanent atrial fibrillation during the treatment with omega-3 polyunsaturated fatty acids.

Nikonova Yu. N., Koziolova N. A., Shilova Ya. E., Agafonov A. V., Polyanskaya E. A.

Keywords: omega-3 fatty acids, atrial fibrillation, CHF

DOI: 10.18087/rhfj.2013.4.1832

Background. Cardio- and nephroprotective effects of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in the treatment of CHF patients, who have had ACS and presently have atrial fibrillation (AF), are a subject of intensive studying and implementing in clinical practice. Aim. Evaluating the time course of CHF and the regression of structural and functional remodeling of heart and kidneys in patients with CHF of ischemic etiology associated with permanent AF receiving ω-3 PUFAs. Materials and methods. 60 patients with CHF of ischemic etiology associated with permanent AF were examined and randomized to two equal groups for identification of ω-3 PUFA cardio- and nephroprotection as compared with the standard therapy for CHF. The treatment duration was 6 months. Structure and function of the heart and kidneys were evaluated using standard echoCG with tissue visualization of diastolic movement rates of mitral valve annulus and measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP), glomerular filtration rate, creatinine clearance, cystatin C, and tissue inhibitor of matrix proteinases-1 (ТIMP-1) were performed. Results. Addition of ω-3 PUFAs to the standard therapy of patients with CHF of ischemic etiology associated with permanent AF improves the clinical course of disease, enhances the exercise tolerance as shown by results of 6min walk test (p<0.001), reduces atrial and ventricular myocardial stress as evaluated by changes in NT-proBNP (p=0.036), alleviates diastolic dysfunction (p<0.001) and LV myocardial hypertrophy (p=0.034), increases LV EF (p<0.001), provides regression of kidney function disorders as shown by the evaluation of cystatin C changes (p=0.002), and restores favorable collagenolysis in myocardial and renal intracellular matrix as shown by TIMP-1 changes (p<0.001). Conclusion. Omega-3 PUFAs added to the therapy of patients with CHF and permanent AF display pronounced cardio- and nephroprotective properties by improving the clinical condition of patients and by favorable structure and function remodeling of the left-side heart and kidneys due to prevention of fibrosis and alleviation of myocardial stress.
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Nikonova Yu.N., Koziolova N.A., Shilova Ya.E. et al. Regression of structural and functional rearrangements in heart and kidneys of patients with chronic heart failure in combination with permanent atrial fibrillation during the treatment with omega-3 polyunsaturated fatty acids. Russian Heart Failure Journal. 2013;14 (4):181-190

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