2013


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2013/№6

Effect of polyunsaturated fatty acids on myocardial metabolism, heart contractility and arrhythmogenic potential in patients with ischemic heart disease and atrial fibrillation

Ismailov A. A., Grishaev S. L., Nikiforov V. S., Sukhov V. Yu., Solntsev V. N.

Keywords: omega-3 polyunsaturated fatty acids, myocardial perfusion tomostsintigraphy synchronized with ECG, atrial fibrillation

DOI: 10.18087/rhj.2013.6.1884

Background. Atrial fibrillation (AF) is a leading disorder of heart rhythm in IHD. The «uрstream» therapy is considered an option to suppress AF using ω-3 polyunsaturated fatty acid (PUFA) drugs not belonging to anti-arrhythmics. Aim. Studying the effect of a ω-3 PUFA drug (Omacor) added to the standard anti-anginal therapy on the lipid profile, heart contractility and arrhythmogenic potential in IHD patients with paroxysmal AF; evaluating changes in myocardial metabolism using perfusion and metabolic single-photon emission computed tomography (SPECT) of the heart. Materials and methods. The study involving 129 patients evaluated results of 6month treatment with ω-3 PUFA in patients with IHD and recurrent AF. At the end of 6month treatment, serum LDL–C levels were significantly increased from baseline in the main group (p<0.05). After the 6month anti-anginal treatment supplemented with ω-3 PUFA administered to IHD patients with paroxysmal AF, SPECT parameters significantly differed in the correlation structure of perfusion and metabolic effects and changes in these parameters with informativity up to 81 %. Most significant changes (р<0.0001) were observed in 45 patients who received ω-3 PUFA for 6 months; for these patients, the mean time of stopping AF was 244.41±62.27 min (p>0.05). ω-3 PUFA exerted a considerable effect on changes in the lipid spectrum, including increased LDL–C and reduced TG. Conclusion. Addition of ω-3 PUFA to the anti-arrhythmic therapy is a pathogenetically justified method for stopping AF in patients with IHD; this method reduces the number of AF episodes (mean, by 50 %, р<0.0001) and shortens the AF stopping time (mean, by 290±61.2 min, р<0.0001).
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Ismailov A. A., Grishaev S. L., Nikiforov V. S. et al. Effect of polyunsaturated fatty acids on myocardial metabolism, heart contractility and arrhythmogenic potential in patients with ischemic heart disease and atrial fibrillation. Russian Heart Journal. 2013;12(6):385-390

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