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Acidi grassi omega 3 e fibrillazione atriale

Un'alta concentrazione sierica di acidi grassi omega-3 a catena lunga (acido eicosapentaenoico, docosaesaenoico e docosapentaenoico) è associata ad un basso rischio di fibrillazione atriale. E' quanto emerge da uno studio prospettico condotto in Finlandia su 2174 uomini. Che gli acidi grassi omega-3 potessero proteggere da aritmie cardiache era già stato evidenziato in una serie di studi clinici e di elettrofisiologia e questo studio non fa altro che aggiungere un nuovo tassello all'ipotesi di un effetto antiaritmogerno dell'olio di pesce. Tra gli acidi grassi, è in particolare l'acido docosaesaenoico che contribuisce maggiormente all'azione protettiva. Gli acidi grassi omega-3 a catena intermedia, come l'acido alfa linolenico non sembrano invece avere effetto protettivo contro l'aritmia atriale, anche se nell'organismo vengono in parte trasformati in acidi grassi a catena più lunga.

Serum long-chain n-3 polyunsaturated fatty acids and risk of hospital diagnosis of atrial fibrillation in men

Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP.

Circulation 2009;120:2315-2321

BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia. Regular fish consumption has been shown to reduce the risk of AF in some but not all studies. Long-chain n-3 polyunsaturated fatty acids (PUFAs) from fish have been suggested to account for these beneficial effects. We tested this hypothesis by studying the association between the serum long-chain n-3 PUFAs eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid and risk of AF in men. METHODS AND RESULTS: A total of 2174 men from the prospective population-based Kuopio Ischemic Heart Disease Risk Factor Study, 42 to 60 years old and free of AF at baseline in 1984 to 1989, were studied. During the average follow-up time of 17.7 years, 240 AF events occurred. In the Cox proportional hazards model, the multivariable-adjusted hazard ratio in the highest (>5.33%) versus the lowest (<3.61%) quartile of eicosapentaenoic acid plus docosapentaenoic acid plus docosahexaenoic acid was 0.65 (95% confidence interval 0.44 to 0.96, P for trend=0.07). Evaluated individually, only serum docosahexaenoic acid was associated with the risk of AF (hazard ratio in the highest versus the lowest quartile 0.62, 95% confidence interval 0.42 to 0.92, P for trend=0.02). Exclusion of subjects (n=233) with myocardial infarction or congestive heart failure either at baseline or that preceded the AF event during follow-up slightly strengthened the associations. Serum intermediate chain-length n-3 PUFA, alpha-linolenic acid, or hair methylmercury concentration were not associated with the risk. CONCLUSIONS: An increased concentration of long-chain n-3 PUFAs in serum, a marker of fish or fish oil consumption, may protect against AF. Serum docosahexaenoic acid concentration had the greatest impact.

Circulation 2009;120:2315-2321