Effects of marine n-3 fatty acids on circulating levels of soluble adhesion molecules in patients with chronic heart failure.

Inflammatory markers as circulating soluble cellular adhesion molecules (sCAMs) and high sensitive C-reactive protein (hsCRP) are elevated in patients with chronic heart failure (CHF), and may constitute an increased risk of adverse outcome. Marine n-3 polyunsaturated fatty acids ( n-3 PUFA) may have anti-inflammatory effect and reduce levels of sCAMs (soluble intercellular adhesion molecule-1 (sICAM-1), vascular adhesion molecule-1 (sVCAM-1), P-selectin) and hsCRP. In a randomized, controlled trial, 138 patients with NYHA class II-III CHF were allocated to receive a daily supplement of 0.9 g of n-3 PUFA or olive oil for 24 weeks. After supplementation, no significant changes occurred in sCAMs or hsCRP after adjusting for possible confounders. However, a significant reduction was observed in sP-selectin in patients receiving n-3 PUFA, but this result was only of borderline significance in a between-group analysis. In conclusion, a daily supplement with 0.9 g of n-3 PUFA does not significantly affect plasma levels of sCAMs or hs-CRP in patients with CHF. n-3 PUFA may reduce sP-selectin, indicating a possible effect on platelet (and endothelial) activation. The results also indicate that the low dose of n-3 PUFA used in many intervention trials does not have deleterious effects on sCAMs or hsCRP.

Soluble adhesion molecules in healthy subjects: a dose-response study using n-3 fatty acids.

BACKGROUND AND AIM: Long-chain n-3 polyunsaturated fatty acids (PUFA) may protect against atherosclerotic disease, and serum levels of soluble cellular adhesion molecules (sCAMs) possibly reflect the inflammatory process underlying atherosclerosis. We studied the effect of n-3 PUFA dietary supplementation on the serum levels of sP-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular adhesion molecule-1 (sVCAM-1), and the correlation between sCAMs and the fatty acid composition of granulocyte membranes. METHODS AND RESULTS: Sixty healthy volunteers were randomly assigned to receive a daily supplement of n-3 PUFA 6.6 g, n-3 PUFA 2.0 g, or olive oil for 12 weeks in a double blind design. A significant negative correlation was found between serum sICAM-1 levels and the DHA content of granulocyte membranes at entry. After supplementation with 6.6 g of n-3 PUFA, there was a significant decrease only in sP-selectin, which a gender subanalysis showed to be more marked in men. Among the women, there was a significant decrease in sICAM-1 in the PUFA 2.0 g group and a significant increase in sVCAM-1 in the PUFA 6.6 g group. CONCLUSIONS: The results indicate that high-dose supplementation with n-3 PUFA decreases sP-selectin levels in healthy subjects, thus suggesting a decrease in platelet reactivity or endothelial activation. However, the effect of n-3 PUFA on sCAMs is complex and may depend on gender and n-3 PUFA dose.

A semi-automated method to quantify left ventricular diastolic inflow propagation by magnetic resonance phase velocity mapping.

A new method of analysis was used for clinical magnetic resonance phase velocity mapping (PVM) to quantify propagation speed (PS) of early diastolic left ventricular (LV) inflow. A group of older volunteers (OV; n = 21, age 58+/-11 years) and a group of aortic stenosis patients (AS; n = 21, age 69+/-8 years) were studied. PVM was used to measure diastolic inflow in the LV outflow tract plane. PS was quantified by a semi-automated method (Auto) and by an operator (Manual). The mean+/-SD PS was 0.71+/-0.21 (Auto) and 0.67+/-0.23 (Manual) m/sec in the OV group, versus 0.49+/-0.28 (Auto) and 0.43+/-0.18 m/sec (Manual) in the AS group. There were no differences in peak transmitral E-wave (P = 0.70) between OV and AS. However, there were differences in PS-Auto (P = 0.0079) and PS-Manual (P = 0.0007) between the two groups. PS is a promising index for identifying diastolic LV dysfunction in AS patients. The semi-automated technique is a practical approach for quantifying LV filling.

Magnetic resonance imaging of blood velocity distribution around St. Jude medical aortic valves in patients.

BACKGROUND AND AIMS OF THE STUDY: Complications after replacement of diseased heart valves with mechanical prostheses may be related to fluid dynamic disturbances. Magnetic resonance velocity mapping may allow quantitative, non-invasive, serial assessment of the blood velocity distribution around prosthetic heart valves in patients. MATERIAL AND METHODS: Velocity mapping was performed in six patients with aortic St. Jude Medical valves. Axial velocity components were measured at three positions near the valve and correlated with earlier in vitro results and with earlier invasive measurements. RESULTS: The velocity profiles downstream of the valve prostheses reflected the valve design and thus confirmed previous findings. In the one diameter downstream position blood flow velocities accelerated initially through the lateral orifices of the valve. Later in the acceleration phase the velocity profile became skewed and the antegrade velocity components increased in the part of the vessel corresponding to the central slit of the valve. Retrograde velocities occurred in part of the lateral orifice regions. CONCLUSIONS: MR velocity mapping provides valuable information on velocity fields around prosthetic bileaflet aortic valves. The velocity fields from the present study disclose qualitative similarity to those previously obtained. The present study, however, suggests a more skewed velocity profile than predicted from former studies. More extensive studies on larger patient groups should be performed, also with other valve types in order to establish a bank of reference data.