Effects of omega-3 polyunsaturated fatty acids on fibrosis, endothelial function and myocardial performance, in ischemic heart failure patients

Clin Nutr. 2019 Jun;38(3):1188-1197. doi: 10.1016/j.clnu.2018.04.017. Epub 2018 May 3.


Background & aims: Polyunsaturated fatty acids (PUFAs) may affect the cardiovascular system with a multiplicity of mechanisms. We assessed the effects of omega-3 PUFAs supplements on inflammation, fibrosis, left ventricle performance and endothelial function of ischemic heart failure (HF) patients.

Methods: In this double-blind, placebo controlled, cross-over trial we enrolled 31 patients with ischemic HF, followed by a 6-week wash-out period. Omega-3 PUFAs (2 g daily, 8 weeks) were administered PO in the intervention arm. Left ventricle ejection fraction (EF), global longitudinal strain and the ratio E/e' (early ventricular filling to early mitral annulus velocities)were measured. Endothelial function was evaluated by flow mediated dilation and myocardial fibrosis by soluble ST2. High sensitive C Reactive protein (hsCRP) levels were measured as an inflammatory marker.

Results: Treatment with omega-3 PUFA, compared to placebo, improved: left ventricle EF (percent increased by 4.7% vs 1.7%); global longitudinal strain (decreased by -10.6% vs -2.3%); the E/e' ratio (decreased by -9.47% vs -2.1%); ST2 levels (decreased by -4.53% vs -2.37%); flow mediated dilation (percent increased by 44% vs. 11% and hsCRP levels (decreased by -6.13% vs 4.35%) (p < 0.05 for all).

Conclusion: Short term treatment with omega-3 PUFAs in subjects with stable ischemic HF improved inflammatory and fibrotic status as well as endothelial function in parallel with systolic and diastolic performance of left ventricle. These findings provide further insights regarding the impact of omega-3 PUFAs administration on left ventricle performance indices, systemic inflammation and fibrosis biomarkers in patients with ischemic HF.

Keywords: Endothelial function; Fibrosis; Heart failure; Inflammation; Left ventricle function; Omega-3 polyunsaturated fatty acids.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cross-Over Studies
  • Double-Blind Method
  • Endothelium, Vascular / drug effects*
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / pharmacology*
  • Female
  • Fibrosis / metabolism
  • Heart Failure / metabolism*
  • Humans
  • Inflammation / metabolism
  • Male
  • Middle Aged
  • Ventricular Function, Left / drug effects*


  • Fatty Acids, Omega-3