Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-28T16:20:53.668Z Has data issue: false hasContentIssue false

Cardiac function in children with premature ventricular contractions: the effect of omega-3 polyunsaturated fatty acid supplementation

Published online by Cambridge University Press:  15 May 2018

Taliha Oner*
Affiliation:
SisliEtfal Training and Research Hospital, Department of Pediatric Cardiology, Sisli, Istanbul, Turkey
Rahmi Ozdemir
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Onder Doksöz
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Dildar B. Genc
Affiliation:
Sisli EtfalTraining and Research Hospital, Department of Pediatric Oncology, Sisli, Istanbul, Turkey
Baris Guven
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Savas Demirpence
Affiliation:
Sifa University, Faculty of Medicine, Department of Pediatric Cardiology, Bornova, Izmir, Turkey
Murat M. Yilmazer
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Yilmaz Yozgat
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Timur Mese
Affiliation:
Dr. Behçet Uz Children’s Hospital, Department of Pediatric Cardiology, Alsancak, Izmir, Turkey
Vedide Tavli
Affiliation:
Sifa University, Faculty of Medicine, Department of Pediatric Cardiology, Bornova, Izmir, Turkey
*
Author for correspondence: T. Oner, MD, SisliEtfalTraining and Research Hospital, Department of Pediatric Cardiology, Sisli, 34360 Istanbul, Turkey. Tel: +00 90 212 373 50 00; Fax: +0 212 234 11 21; E-mail: talihaoner@yahoo.com

Abstract

Background

Premature ventricular contractions are accepted as benign in structurally normal hearts. However, reversible cardiomyopathy can sometimes develop. Omega-3 polyunsaturated fatty acids have anti-arrhythmic properties in animals and humans.

Aim

We evaluated left ventricular function in children with premature ventricular contractions with normal cardiac anatomy and assessed the impact of omega-3 fatty acid supplementation on left ventricular function in a prospective trial.

Methods

A total of 25 patients with premature ventricular contraction, with more than 2% premature ventricular contractions on 24-hour Holter electrocardiography, and 30 healthy patients were included into study. All patients underwent electrocardiography, left ventricular M-mode echocardiography, and myocardial performance index testing. Patients with premature ventricular contraction were given omega-3 fatty acids at a dose of 1 g/day for 3 months, and control echocardiography and 24-hour Holter electrocardiography were performed. Neither placebo nor omega-3 fatty acids were given to the control group.

Results

Compared with the values of the control group, the patients with premature ventricular contraction had significantly lower fractional shortening. The myocardial performance index decreased markedly in the patient groups. The mean heart rate and mean premature ventricular contraction percentage of Group 2 significantly decreased in comparison with their baseline values after the omega-3 supplementation.

Conclusion

In conclusion, premature ventricular contractions can lead to systolic cardiac dysfunction in children. Omega-3 supplementation may improve cardiac function in children with premature ventricular contractions. This is the first study conducted in children to investigate the possible role of omega-3 fatty acid supplementation on treatment of premature ventricular contractions.

Type
Original Articles
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Dimitrow, PP, Jawien, M. Pleiotropic, cardioprotective effects of omega-3 polyunsaturated fatty acids. Mini Rev Med Chem 2009; 9: 10301039.CrossRefGoogle ScholarPubMed
2. Leaf, A, Kang, JX, Xiao, YF, Billman, GE. Clinicalprevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 2003; 107: 26462652.CrossRefGoogle Scholar
3. Kang, JX, Leaf, A. Antiarrhythmic effects of polyunsaturated fatty acids. Circulation 1996; 94: 17741780.CrossRefGoogle ScholarPubMed
4. Christensen, JH. Omega-3 polyunsaturated fattyacids and heart ratevariability. Front Physiol 2011; 2: 84.CrossRefGoogle Scholar
5. Christensen, JH, Schmidt, EB. Autonomic nervous system, heart rate variability and n-3 fatty acids. J Cardiovasc Med (Hagerstown) 2007; 8 (Suppl 1): S19S22.CrossRefGoogle ScholarPubMed
6. Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 10721083.CrossRefGoogle ScholarPubMed
7. Tei, C, Ling, LH, Hodge, DO, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357366.Google ScholarPubMed
8. Kakavand, B, Ballard, HO, Disessa, TG. Frequent ventricular premature beats in children with a structurally normal heart: a cause for reversible left ventricular dysfunction? Pediatr Cardiol 2010; 31: 986990.CrossRefGoogle Scholar
9. Sun, Y, Blom, NA, Yu, Y, et al. The influence of premature ventricular contractions on left ventricular function in asymptomatic children without structural heart disease: an echocardiographic evaluation. Int J Cardiovasc Imaging 2003; 19: 295299.CrossRefGoogle ScholarPubMed
10. Hasdemir, C, Kartal, Y, Sımsek, E, et al. Time course of recovery of left ventricular systolic dysfunction in patients with premature ventricular contraction-induced cardiomyopathy. Pacing Clin Electrophysiol 2013; 36: 612617.CrossRefGoogle ScholarPubMed
11. Lampert, R, Joska, T, Burg, MM, Batsford, WP, McPherson, CA, Jain, D. Emotional and physical precipitants of ventricular arrhythmia. Circulation. 2002; 106: 18001805.CrossRefGoogle ScholarPubMed
12. Papiashvili, G, Tabagari-Bregvadze, N, Brugada, J. Anxıety levels in patıents wıth paroxysmal supraventrıcular tachycardıa ın relatıon wıth the patıent demographıcs type of supraventrıcular tachycardıa and their personalıty type. Georgian Med News 2017; 267: 6165.Google Scholar
13. Del Franco, A, Gualandi, F, Malagù, M, et al. A clinical case of catecholaminergic polymorphic ventricular tachycardia: the clinical suspicious and the need of genetics. Cardiology 2017; 138: 6972.CrossRefGoogle ScholarPubMed
14. Lampert, R. Mental stress and ventricular arrhythmias. Curr Cardiol Rep 2016; 18: 118.CrossRefGoogle ScholarPubMed
15. Beaufort-Krol, GC, Dijkstra, SS, Bink-Boelkens, MT. Natural history of ventricular premature contractions in children with a structurallynormalheart: Does origin matter? Europace 2008; 10: 9981003.CrossRefGoogle ScholarPubMed
16. Leaf, A, Kang, JX, Xiao, YF, Billman, GE. n-3 fatty acids in the prevention of cardiac arrhythmias. Lipids 1999; 34 (Suppl): S187S189.CrossRefGoogle ScholarPubMed
17. Leaf, A, Xiao, YF, Kang, JX, Billman, GE. Membrane effects of the n-3 fish oil fatty acids, which prevent fatal ventricular arrhythmias. J Membr Biol 2005; 206: 129139.CrossRefGoogle ScholarPubMed
18. Shah, AP, Ichiuji, AM, Han, JK, et al. Cardiovascular and endothelial effects of fish oil supplementation in healthy volunteers. J Cardiovasc Pharmacol Ther 2007; 12: 213219.CrossRefGoogle ScholarPubMed
19. Khan, F, Elherik, K, Bolton-Smith, C, et al. The effects of dietary fatty acid supplementation on endothelial function and vascular tone in healthy subjects. Cardiovasc Res 2003; 59: 955962.CrossRefGoogle ScholarPubMed
20. Hooper, L, Thompson, RL, Harrison, RA, et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ 2006; 332: 752760.CrossRefGoogle ScholarPubMed
21. Smith, PJ, Blumenthal, JA, Babyak, MA, et al. Association between n-3 fatty acid consumption and ventricular ectopy after myocardial infarction. Am J Clin Nutr 2009; 89: 13151320.CrossRefGoogle ScholarPubMed
22. Gogolashvili, NG, Litvinenko, MV, Pochikaeva, TN, et al. Possibilities of a preparation omega-3 polyunsaturated fatty acids in the treatment of patients with ventricular arrhythmias and myocardial infarction. Kardiologiia 2011; 51: 2831.Google ScholarPubMed
23. Nishimura, M, Nanbu, A, Komori, T, et al. Eicosapentaenoic acid stimulates nitric oxide production and decreases cardiac noradrenaline in diabetic rats. Clin Exp Pharmacol Physiol 2000; 27: 618624.CrossRefGoogle ScholarPubMed
24. Hamazaki, K, Itomura, M, Huan, M, et al. Effect of omega-3fatty acid-containing phospholipids on blood catecholamine concentrations in healthy volunteers: a randomized, placebo-controlled, double-blind trial. Nutrition 2005; 21: 705710.CrossRefGoogle Scholar
25. Geelen, A, Brouwer, IA, Schouten, EG, et al. Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans. Am J Clin Nutr 2005; 81: 416420.CrossRefGoogle ScholarPubMed
26. Jurko, A Jr, Jurko, A, Minarik, M. Doppler-derived myocardial performance index in healthy children. Bratisl Lek Listy 2011; 112: 7779.Google ScholarPubMed
27. Flanagan, R, Cain, N, Tatum, GH, et al. Left ventricular myocardial performance index change for detection of acute cellular rejection in pediatric heart transplantation. Pediatr Transplant 2013; 17: 782786.CrossRefGoogle ScholarPubMed
28. Mikkelsen, KV, Moller, JE, Bie, P, et al. Tei index and neurohormonal activation in patients with incident heart failure: serial changes and prognostic value. Eur J Heart Fail 2006; 8: 599608.CrossRefGoogle ScholarPubMed
29. Chrysohoou, C, Metallinos, G, Georgiopoulos, G, et al. Short term omega-3 polyunsaturated fatty acid supplementation induces favorable changes in right ventricle function and diastolic filling pressure in patients with chronic heart failure; a randomized clinical trial. Vascul Pharmacol 2016; 79: 4350.CrossRefGoogle ScholarPubMed
30. Maffei, S, De Felice, C, Cannarile, P, et al. Effects of ω-3 PUFAs supplementation on myocardial function and oxidative stress markers in typical Rett syndrome. Mediators Inflamm 2014; 2014: 983178.CrossRefGoogle ScholarPubMed
31. Moertl, D, Hammer, A, Steiner, S, Hutuleac, R, Vonbank, K, Berger, R. Dose-dependent effects of omega-3-polyunsaturated fatty acids on systolic left ventricular function, endothelial function, and markers of inflammation in chronic heart failure of nonischemic origin: a double-blind, placebo-controlled, 3-arm study. Am Heart J 2011; 161: 915.e1-9.CrossRefGoogle Scholar