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03.04.2017

Fish oil for heart failure

We don't want to exaggerate the effect, but supplementation with fish oil - omega-3 fatty acids DHA and EPA - may help mitigate heart failure. This is suggested in a meta-study that Chinese cardiologists at Chongqing Medical University published in Nutrients. It looks as though fish oil is particularly interesting for people who suffer from a form of heart failure that is found in strength athletes who use illegal anabolic steroids.

Study
The researchers consulted nine previously published trials in which researchers had given fish oil to a total of 800 participants who had heart failure. They put the data from the trials together and re-analysed it.

Results
The made a funnel plot from the findings from the trial and found no indications of bias. So it is unlikely that cardiologists who had studied the effect of fish oil on heart failure only published positive results and left out the less attractive results.

Fish-oil supplementation lowered the concentration of the proteins brain natriuretic peptide [BNP] and N-terminal pro b-type natriuretic peptide [NT-pro-BNP] in the blood. These proteins come from heart cells, which make more of these proteins when they are having a hard time. For cardiologists, the concentrations of BNP and NT-pro-BNP are indicators of heart failure: the higher they are, the worse the situation.

Supplementation with fish oil led to a rise in the amount of blood that the left ventricle of the heart pumped into the body [left ventricular ejection fraction; LVEF], but the effect was not significant. In the figure below, the horizontal axis shows the standardised mean differences.

There are different kinds of heart failure. Ischaemic cardiomyopathy [ICM] is where the heart does not get enough blood supply, as a result of which the heart muscle shrinks. In dilated cardiomyopathy [DCM], the form of heart failure that cardiologists often find in pharmacological strength athletes, the heart muscle is overworked, and the left ventricle of the heart muscle has become deformed so the heart no longer works properly.

In people with ICM, supplementation had no significant positive effect on the amount of blood that the left ventricle of the heart could pump into the body. In those with DCM, there is a positive effect.

Whether fish-oil supplementation has an effect depends partly on the dose given. Most trials in which the researchers used 1 g fish oil daily were not a success; trials with 2 g fish oil were successful.

A second factor that influenced success was the length of the trial. Trials in which the participants were given fish oil for longer than six months [long-term] were mostly successful; trials that lasted less [short-term] were not.

Conclusion
"These findings suggest that omega-3 polyunsaturated fatty acids might be beneficial to heart failure patients, but the evidence is not definitive," the researchers concluded.

"In the future, high-quality randomised controlled trials with large numbers of participants are needed to investigate the optimal dosage and components of omega-3 polyunsaturated fatty acids to improve the prognostic outcomes of heart failure patients."

Source:
Nutrients. 2016 Dec 30;9(1).

More:
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