Relationship of Circulating Vegetable Omega-3 to Prognosis in Patients With Heart Failure
Relationship of Circulating Vegetable Omega-3 to Prognosis in Patients With Heart Failure
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DOI：
10.1016/j.jacc.2022.08.771
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发表时间：
2022-10-24
影响因子：
24
通讯作者：
Bayes-Genis, Antoni
中科院分区：
文献类型：
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作者：
Lazaro, Iolanda;Lupon, Josep;Bayes-Genis, Antoni
背景迫切需要具有成本效益的策略来提高心力衰竭（HF）患者的生活质量。几项研究报道了海洋omega-3脂肪酸和植物性饮食模式对HF预后的益处。补充剂本研究的目的是探索饮食α-亚麻酸（ALA），主要的植物omega-3，方法测定血清磷脂中ALA的含量，通过气相色谱法对905例不同病因引起的非卧床HF患者进行了为期2.4年的中位随访，（范围：0.02-3年）、140例全因死亡、85例心血管（CV）死亡和141例首次HF住院（全因死亡和首次HF住院的复合终点，n = 238）。使用考克斯回归分析，我们观察到，与血清磷脂中ALA最低四分位数（Q1）的患者相比，3个上四分位数（Q2-Q4）的患者显示全因死亡和首次HF住院的复合风险降低（HR：0.61; 95% CI：0.46-0.81）。观察到全因死亡率在统计学上显著降低（HR：0.58; 95% CI：0.41-0.82），CV死亡（HR：0.51; 95% CI：0.32-0.80），首次HF住院（HR：0.58; 95% CI：0.40-0.84），以及CV死亡和HF住院的复合终点（HR：0.58; 95% CI：0.42-0.79）。结论：在中期随访期间，血清磷脂中ALA水平低于25%的HF患者预后较差。与最高水平的人相比。这可能是一个目标人群，在其中测试富含ALA的饮食干预措施，以提高生活质量。(c)2022年，美国心脏病学会基金会。
BACKGROUND There is an urgent need for cost-effective strategies to promote quality of life in patients with heart failure (HF). Several studies reported benefits in HF prognosis for marine omega-3 fatty acids and plant-based dietary patterns.OBJECTIVES The aim of this study was to explore whether dietary alpha-linolenic acid (ALA), the main plant omega-3, relates to a better HF prognosis.METHODS ALA was determined in serum phospholipids (which reflect long-term dietary ALA intake and metabolism) by gas chromatography in 905 ambulatory patients with HF caused by different etiologies.RESULTS After a median follow-up of 2.4 years (range: 0.02-3 years), 140 all-cause deaths, 85 cardiovascular (CV) deaths, and 141 first HF hospitalizations (composite of all-cause death and first HF hospitalization, n = 238) were documented. Using Cox regression analyses, we observed that, compared with patients at the lowest quartile of ALA in serum phospholipids (Q1), those at the 3 upper quartiles (Q2-Q4) exhibited a reduction in the risk of composite of all-cause death and first HF hospitalization (HR: 0.61; 95% CI: 0.46-0.81). Statistically significant reductions were observed for all-cause death (HR: 0.58; 95% CI: 0.41-0.82), CV death (HR: 0.51; 95% CI: 0.32-0.80), first HF hospitalization (HR: 0.58; 95% CI: 0.40-0.84), and the composite of CV death and HF hospitalization (HR: 0.58; 95% CI: 0.42-0.79).CONCLUSIONS HF patients with bottom 25% ALA levels in serum phospholipids had a worse prognosis during a midterm follow-up compared with those with the highest levels. This might be a target population in whom to test dietary ALA-rich interventions to promote quality of life. (c) 2022 by the American College of Cardiology Foundation.