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欧米茄-3 脂肪酸和心律失常

Mason D Marcus¹, Mark S Link¹

¹Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX.

|August 5, 2024

概括

欧米茄-3脂肪酸 (n-3PUFAs) 在心律方面显示出不同的结果. 虽然一些研究表明有好处,但高剂量可能会增加心房动 (AF) 的风险,但机制尚不清楚.

科学领域:

心脏病学
药理学
生物化学

背景情况:

欧米茄3多不和脂肪酸 (n-3PUFA) 已被研究为促和抗不律的作用.
早期研究表明n-3PUFA可以预防心脏突然死亡和心房动 (AF).
然而,最近的大型随机试验对抗心律失常的益处产生了矛盾的结果.

研究的目的:

评估n-3PUFA对心律失常的复杂且往往相互矛盾的作用,特别是心律失常.
评估目前关于n-3PUFA补充剂在心血管预防和AF治疗中的有效性和安全性的临床证据.
研究特定的n-3PUFA配方和剂量的潜在促节律作用.

主要方法:

临床前研究和人类临床试验的审查,包括随机对照试验 (RCT).
对研究中度和高剂量的n-3PUFAs (包括eicosapentaenoic acid (EPA) 和docosahexaenoic acid (DHA)) 进行心血管预防的大型当代RCT数据的分析.
与对照组相比,在接受n-3PUFA的参与者中检查了与事件AF相关的发现.

主要成果:

累积的证据不支持n-3PUFA补充剂用于术后的AF或二次AF预防.
与安慰剂相比,几项大型试验表明,高剂量的n-3PUFA (伊可萨乙烯或EPA+DHA) 对发生的AF有微小而显著的剂量依赖性增加.
在单疗法和混合疗法中观察到这些前节律的发现,但潜在的机制仍然未知.

结论:

对于预防心律失常,特别是心律失常的n-3PUFA的临床效用是不确定的,并可能引起争议.
高剂量的n-3PUFA补充剂,包括特殊配方如icosapent ethyl,可能会增加发 AF 的风险.
需要进一步的研究,以阐明EPA,DHA及其代谢物的复杂促和阻节律机制,并确定患有较高风险的患者子组.

关键词:

心房动多可萨赫萨诺酸乙酸脂肪酸,欧米茄三

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