Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease

142 Pages·2016·12.07 MB·English

ISSN 1949-8462 (online)
World Journal of
Cardiology
World J Cardiol 2016 February 26; 8(2): 114-246
Published by Baishideng Publishing Group Inc
W J C World Journal of
Cardiology
Editorial Board
2014-2017
The World Journal of Cardiology Editorial Board consists of 410 members, representing a team of worldwide experts
in cardiology. They are from 46 countries, including Argentina (3), Australia (7), Austria (6), Belgium (2), Brazil (8),
Canada (11), China (37), Croatia (1), Cuba (1), Cyprus (1), Czech Repoublic (2), Denmark (3), Egypt (1), Finland (3),
France (3), Germany (31), Greece (10), Hungary (5), India (4), Iran (2), Ireland (1), Israel (4), Italy (61), Japan (32),
Kosovo (1), Malaysia (1), Mexico (1), Morocco (1), Netherlands (9), New Zealand (1), Nigeria (2), Norway (2), Poland
(8), Portugal (2), Saudi Arabia (2), Singapore (3), Slovenia (1), South Korea (9), Spain (14), Switzerland (2), Thailand (3),
Turkey (13), United Arab Emirates (1), United Kingdom (20), United States (72), Uruguay (2), and Venezuela (1).
EDITORS-IN-CHIEF Zhonghua Sun, Perth Jacqueline WL Saw, Vancouver
Jian-Jun Li, Beijing Caroline Sirois, Levis
Giuseppe De Luca, Novara Sara S Nunes Vasconcelos, Toronto
Nathan D Wong, Irvine
Austria
GUEST EDITORIAL BOARD Alexander Binder, Graz
Mariann Gyongyosi, Vienna China
MEMBERS
Rudolf Kirchmair, Innsbruck
Shih-Tai Chang, Putz Feng Cao, Xi'an
Deddo Moertl, Vienna
Mien-Cheng Chen, Kaohsiung Xiao-Shu Cheng, Nanchang
Gert Reiter, Graz
Juei-Tang Cheng, Tainan Jie Du, Beijing
Ioannis Tentzeris, Vienna
Woei-Jer Chuang, Tainan Jun-Bao Du, Beijing
Shih-Hung Hsiao, Kaohsiung Deng-Feng Gao, Xi'an
Wei-Chun Huang, Kaohsiung Chang-Qing Gao,
Tsung-Ming Lee, Tainan Belgium Kai-Zheng Gong, Yangzhou
Tzong-Shyuan Lee, Taipei Kai Huang, Wuhan
BSN Alzand, Ronse
Jiun-Yi Li, Taipei Bin Jiang, Beijing
Paul Vermeersch, Antwerpen
Gen-Min Lin, Hualien Zhi-Yong Li, Nanjing
Ping-Yen Liu, Tainan Tong Liu, Tianjin
Kou-Gi Shyu, Taipei Jing-Ping Sun, Hong Kong
Chin-Hsiao Tseng, Taipei Brazil Jun Tao, Guangzhou
Malcolm J Underwood, Hong Kong
Edimar A Bocchi, Sao Paulo
MEMBERS OF THE EDITORIAL Song Wan, Hong Kong
Antonio CC de Carvalho, Rio de Janeiro
BOARD Guilherme V Guimaraes, Sao Paulo Yi Wan, Xi'an
Chi-Ming Wong, Hong Kong
Ronaldo Lima, Rio de Janeiro
Jian-Bo Wu, Luzhou
Christiane Malfitano, Sao Paulo
Hai-Wei Wu, Nanjing
Antonio P Mansur, Sao Paulo
Argentina Yong Xu, Nanjing
Gilberto De Nucci, Campinas
Chen-Jiang Ying, Wuhan
Mariano Falconi, Buenos Aires Andre Talvani, Ouro Preto
Hong-Kun Zhang, Hangzhou
Ricardo R Forastiero, Buenos Aires
Jiu-Chang Zhong, Shanghai
Gaston A Rodriguez-Granillo, Buenos Aires
Canada
Australia Rodrigo Bagur, Quebec Croatia
Jagdish Butany, Toronto
Christoph E Hagemeyer, Melbourne Mohamed Chahine, Québec Viktor Culic, Split
Christian Hamilton-Craig, Brisbane Paul Farand, Sherbrooke
Kwok Ming Ho, Perth Michael E Farkouh, Toronto
Tin Kyaw, Melborune Robert Gros, London
Cuba
Kazuko Masuo, Melbourne Joseph F Ndisang, Saskatoon
Hamish C Prosser, Sydney Simon W Rabkin, Vancouver Fidel M Caceres-Loriga, Havana
WJC|www.wjgnet.com I March 26, 2014
Fabio Esposito, Milan
Pompilio Faggiano, Brescia
Cyprus Greece Khalil Fattouch, Palermo
Amalia Forte, Naples
Christos Eftychiou, Nicosia Dimitrios Farmakis, Athens
Chiara Fraccaro, Rovigo
Ignatios Ikonomidis, Athens
Mario Gaudino, Rome
Theofilos M Kolettis, Ioannina
Sandro Gelsomino, Florence
Antigone Lazou, Thessaloniki
Czech Repoublic Massimo Iacoviello, Bari
Konstantinos Letsas, Athens
Massimo Imbriaco, Napoli
Pavel Osmancik, Prague Kosmas I Paraskevas, Larissa
Ciro Indolfi, Catanzaro
Jan Sochman, Prague Elias Rentoukas, Athens
Maurizio E Landolina, Pavia
Georgios Tagarakis, Thessaloniki
Chiara Lazzeri, Florence
Theodoros Xanthos, Athens
Jacopo M Legramante, Rome
Michael Zairis, Piraeus
Denmark Antonio Loforte, Bologna
Rosalinda Madonna , Chieti
Louise L Schierbeck, Copenhagen NV
Olivia Manfrini, Bologna
Jacob Tfelt-Hansen, Copenhagen
Hungary Giancarlo Marenzi, Milan
Bo G Winkel, Copenhagen
Raffaele Marfella, Naples
Gergely Feher, Pecs
András Komócsi, Pécs Giovanni Mariscalco, Varese
Béla Merkely, Budapest Franca Di Meglio, Naples
Egypt Attila Nemes, Szeged Pietro A Modesti, Florence
Mohamed E Fawzy, Cairo Albert Varga, Szeged Massimo Napodano, Padua
Daria Nurzynska, Naples
Claudio Passino, Pisa
Salvatore Patanè, Taormina
Finland India Francesco Perticone, Catanzaro
Fausto Biancari, Oulu Amitesh Aggarwal, Delhi Nunzia R Petix, Empoli
Kjell Nikus, Tampere Debasis Das, Kolkata Francesco Petrella, Milan
Jani T Tikkanen, Oulu Yatin Mehta, Gurgaon Mario Petretta, Naples
Nikhil Sikri, Bangalore Carmine Pizzi, Bologna
Marco Pocar, Milan
Roberto Pola, Rome
France Francesco Prati, Rome
Iran
Dominique Charron , Paris Fabio M Pulcinelli, Rome
Joao C Das-Neves-Pereira, Paris Farid Najafi, Kermanshah Andrea Rossi, Verona
Guillaume Leurent, Rennes Mahdi Najafi, Tehran Andrea Rubboli, Bologna
Giovanni Di Salvo, Naples
Giuseppe M Sangiorgi, Rome
Carlo Setacci, Siena
Germany Ireland
Imad Sheiban, Verona
Helmut Acker, Essen Timothy M McGloughlin, Abu Dhabi Giuseppe Stabile, Napoli
Ralf A Benndorf, Halle (Saale) Luca Testa, Milan
Niyazi Cebi, Stade
Emmanuel Chorianopoulos, Heidelberg Israel
Ulrich H Frey, Essen
Robert Dragu, Haifa Japan
Alexander Ghanem, Bonn
Ehud Goldhammer, Haifa
Michael Gotzmann, Bochum Eisuke Amiya, Tokyo
Aviv Mager, Petah Tikva
Takahiro Higuchi, Würzburg Ryuichiro Anan, Miyakonojo
David Rott, Tel Hashomer
Thomas W Jax, Neuss Xian Wu Cheng, Nagoya
Christoph J Jensen, Essen Ikuo Fukuda, Aomori
Beate E Kehrel, Muenster Shin-ichiro Hayashi, Suita
Klaus Kettering, Frankfurt Italy Atsushi Hirohata, Okayama
Korff Krause, Hamburg Toru Hosoda, Isehara
Romualdo Belardinelli, Ancona
Arnt V Kristen, Heidelberg Matteo Bertini, Ferrara Kazuhiro P Izawa, Kawasaki
Philipp C Lurz, Leipzig Riccardo Bigi, Milan Takatoshi Kasai, Tokyo
Thomas Muenzel, Mainz Carlo Bonanno, Vicenza Hajime Kataoka, Oita
Ulrich Nellessen, Stendal Giuseppe Boriani, Bologna Masaya Kato, Hiroshima
Peter E Ong, Stuttgart Natale D Brunetti, Foggia Tomoko S Kato, Tokyo
Guenter Pilz, Hausham Giuseppe Bruschi, Milan Atsuhiko Kawamoto, Kobe
Tienush Rassaf, Düsseldorf Alida LP Caforio, Padova Zhong-Fang Lai, Kumamoto
Bernhard Rauch, Ludwigshafen am Rhein Corrado Carbucicchio, Milan Seiichiro Matsuo, Tokyo
Sonja Schrepfer, Hamburg Oronzo Catalano, Pavia Shin-ichiro Miura, Fukuoka
Andreas Schuster, Goettingen Massimo Chello, Rome Sachio Morimoto, Fukuoka
Guiscard Seebohm, Muenster Quirino Ciampi, Benevento Toshiya Muramatsu , Yokohama
Hans-Jürgen Seyfarth, Leipzig Antonio Cittadini, Naples Koichi Sakabe, Tokyo
Erik Skobel, Aachen Anca I Corciu, Pisa Hiroyuki Sakurai, Chuo-ku
Dirk Skowasch, Bonn Michele Correale, Foggia Akira Sato, Tsukuba
Gustav Steinhoff, Rostock Michele D'Alto, Naples Shinji Satoh, Fukuoka
Michael Steinmetz, Goettingen Fabrizio D'Ascenzo, Turin Hiroshi Satoh, Hamamatsu
Theodor Tirilomis, Goettingen Giuseppe De Luca, Novara Akira Sugawara, Sendai
Rainer Wessely, Cologne Roberto De Ponti, Varese Isao Taguchi, Tochigi
WJC|www.wjgnet.com II March 26, 2014
Masamichi Takano, Inzai Sebastian Szmit, Warsaw
Hiroki Teragawa, Hiroshima
Hiroyasu Ueda, Osaka Turkey
Tadayuki Uetani, Nagoya Bahri Akdeniz, Izmir
Sho-ichi Yamagishi, Kurume Portugal Ismail Biyik, Usak
Hideya Yamamoto, Hiroshima Rui A Providência, Coimbra Murat Can, Zonguldak
Hiroshi Yoshida, Kashiwa Fernando Ribeiro, Aveiro Turgay Celik, Ankara
Yengi U Celikyurt, Kocaeli
Omer F Dogan, Adana
Dursun Duman, Istanbul
Kosovo Saudi Arabia
Nihan Erdogan, Istanbul
Gani Bajraktari, Prishtina T Albacker, Riyadh Tevfik F Ilgenli, Konya
Mouaz H Al-Mallah, Riyadh Fehmi Kacmaz, Sanliurfa
Kaan Kirali, Istanbul
Mehmet Ozaydin, Isparta
Malaysia Murat Ozeren, Mersin
Harris A Ngow, Kuantan Singapore
Koon-Hou Mak, Singapore
Kian Keong Poh, Singapore
United Arab Emirates
Samuel SW Tay, Singapore
Mexico Nicolas Christoforou, Abu Dhabi
Erick Alexanderson, Mexico City
Slovenia
United Kingdom
Mitja Lainscak, Golnik
Morocco Suneil K Aggarwal, London
Abdenasser Drighil, Casablanca Abdallah Al-Mohammad, Sheffield
Umberto Benedetto, Papworth
South Korea Christopher J Boos, Poole
Kyung-Mook Choi, Seoul Geoffrey Burnstock, London
Netherlands Young-Hoon Jeong, Jinju-si Halina Dobrzynski, Manchester
Pierfrancesco Agostoni, Utrecht Hyo-Soo Kim, Seoul Lyndon M Evans, Cardiff
Christos V Bourantas, Rotterdam Cheorl-Ho Kim, Suwon Matthew Ginks, Oxford
Jasper J Brugts, Rotterdam Seong Hwan Kim, Ansan Cathy M Holt, Manchester
Filippo Cademartiri, Rotterdam Young-Guk Ko, Seoul Jamie Y Jeremy, Bristol
Henricus J Duckers, Utrecht Gi-Byoung Nam, Seoul Muhammed Z Khawaja, London
Guido Krenning, Groningen Jong-Min Song, Seoul Babu Kunadian, Liverpool
Frans L Moll, Utrecht Darren R Williams, Gwangju Najma Latif, Harefield
Saagar Mahida, leeds
Martijn C Post, Nieuwegein
Mamas Mamas, Manchester
Salah AM Said, Hengelo
Pankaj K Mishra, Wolverhampton
Spain Shahzad G Raja, London
Sudhir Rathore, Camberley
Ezequiel Alvarez, Santiago de Compostela
New Zealand Miguel A Arias, Toledo Ganesh N Shivu, Ravenshead
Alberto B Berenguer, Valencia Neil A Turner, Leeds
Barry Palmer, Christchurch
Alberto Dominguez-Rodriguez, Tenerife
Julio J Ferrer-Hita, La Laguna
Joaquin De Haro, Madrid
United States
Nigeria Raul Moreno, Madrid
Ivan J Nunez-Gil, Madrid Ola Akinboboye, New York
Rufus A Adedoyin, Ile-Ife
Jesus Millan Nuuez-Cortes, Madrid Arshad Ali, North Platte
Okechukwu S Ogah, Ibadan
Jesus Peteiro, A Coruna Piero Anversa, Boston
Aurelio Quesada, Valencia Ehrin J Armstrong, Denver
Manel Sabate, Barcelona Wilbert S Aronow, Valhalla
Rocio Toro, Cadiz Basem Azab, Staten Island
Norway
Jose M Valdivielso, Lleida Alison E Baird, Brooklyn
Jonas Hallen, Oslo Saravanan Balamuthusamy, Tucson
Serena Tonstad, Oslo Hendrick B Barner, Saint Louis
Marion A Hofmann Bowman, Chicago
Switzerland Danny Chu, Pittsburgh
Paul Erne, Zurich Undurti N Das, Federal Way
Poland
Richard Kobza, Luzern Jose M Dizon, New York
Maciej Banach, Lodz Khalid M Elased, Dayton
Iwona Cicha, Erlangen Sammy Elmariah, Boston
Grzegorz Gajos, Krakow James D Fett, Lacey
Piotr Jankowski, Kraków Thailand Don A Gabriel, Chapel Hill
Maciej K Kurpisz, Poznan Nipon Chattipakorn, Chiang Mai Nisha J Garg, Galveston
Katarzyna M Mizia-Stec, Katowice Rungroj Krittayaphong, Bangkok Cynthia J Girman, North Wales
Jerzy Sacha, Opole Yaowapa Maneerat, Bangkok Mardi Gomberg-Maitland, Chicago
WJC|www.wjgnet.com III March 26, 2014
Robert G Gourdie, Roanoke Jamal S Mustafa, Morgantown Howard S Weber, Hershey
Abdul Hakeem, Little Rock Hiroshi Nakagawa, Oklahoma City Giora Weisz, New York
M Brennan Harris, Williamsburg Navin C Nanda, Birmingham Monte S Willis, Chapel Hill
Robert C Hendel, Miami Surya Nauli, Toledo Michael S Wolin, Valhalla
Gang Hu Baton, Rouge Siyamek Neragi-Miandoab, New York Nathan D Wong, Irvine
Antony Innasimuthu, Pittsburgh Tien MH Ng, Los Angeles Lai-Hua Xie, Newark
Sabzali Javadov, San Juan Chee Yuan Ng, Loma Linda Meifeng Xu, Cincinnati
Shahrokh Javaheri, Mason Gustavo S Oderich, Rochester Zequan Yang, Charlottesville
Kai Jiao, Birmingham Jin O-Uchi, Philadelphia Midori A Yenari, San Francisco
Paul Kurlansky, New York Mohammed S Razzaque, Boston Li Zhang, Wynnewood
Yulong Li, Omaha Jun Ren, Laramie
Ji Li, Buffalo Rahman Shah, Memphis
Zhongmin Li, Sacramento Nian-Qing Shi, Madison
Uruguay
Joseph R Libonati, Philadelphia Boris Z Simkhovich Los, Angeles
Steven E Lipshultz, Detroit Philippe Sucosky, Notre Dame Victor Dayan, Montevideo
Yi-Hwa Liu, New Haven Junhui Sun, Bethesda Juan C Grignola, Montevideo
Suvitesh Luthra, Boston Tahir Tak, Rochester
Anastasios Lymperopoulos, Fort Lauderdale George W Vetrovec, Richmond
Shingo Maeda, Philadelphia Jiang W, Durham
Venezuela
Jawahar L Mehta, Little Rock Mingyi Wang, Baltimore
Jeffrey W Moses, New York Lu Wang, Boston Diego F Davila, Merida
WJC|www.wjgnet.com IV March 26, 2014
W J C World Journal of
Cardiology
Contents Monthly Volume 8 Number 2 February 26, 2016
EDITORIAL
114 Omega 3 and atrial fibrillation: Where are we?
Martino A, Pezzi L, Magnano R, Salustri E, Penco M, Calo’ L
TOPIC HIGHLIGHT
120 Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a
unique background
Ganzetti G, Campanati A, Molinelli E, Offidani A
REVIEW
132 Impact of cardiac magnetic resonance imaging in non-ischemic cardiomyopathies
Kalisz K, Rajiah P
146 Mechanical dyssynchrony and deformation imaging in patients with functional mitral regurgitation
Rosa I, Marini C, Stella S, Ancona F, Spartera M, Margonato A, Agricola E
163 Micromanaging cardiac regeneration: Targeted delivery of microRNAs for cardiac repair and regeneration
Kamps JAAM, Krenning G
180 Genetic testing in congenital heart disease: A clinical approach
Chaix MA, Andelfinger G, Khairy P
MINIREVIEWS
192 Diagnosis and management of patients with asymptomatic severe aortic stenosis
Katayama M, Chaliki HP
201 Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and
strategies
Hendrani AD, Adesiyun T, Quispe R, Jones SR, Stone NJ, Blumenthal RS, Martin SS
211 Novel epigenetic-based therapies useful in cardiovascular medicine
Napoli C, Grimaldi V, De Pascale MR, Sommese L, Infante T, Soricelli A
ORIGINAL ARTICLE
Retrospective Study
220 Red cell distribution width in anemic patients undergoing transcatheter aortic valve implantation
Hellhammer K, Zeus T, Verde PE, Veulemanns V, Kahlstadt L, Wolff G, Erkens R, Westenfeld R, Navarese EP, Merx MW,
Rassaf T, Kelm M
WJC|www.wjgnet.com I February 26, 2016|Volume 8|Issue 2|
World Journal of Cardiology
Contents
Volume 8 Number 2 February 26, 2016
Observational Study
231 Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease
patients
Tritakis V, Tzortzis S, Ikonomidis I, Dima K, Pavlidis G, Trivilou P, Paraskevaidis I, Katsimaglis G, Parissis J, Lekakis J
META-ANALYSIS
240 Biodegradable polymer stents vs second generation drug eluting stents: A meta-analysis and systematic
review of randomized controlled trials
Pandya B, Gaddam S, Raza M, Asti D, Nalluri N, Vazzana T, Kandov R, Lafferty J
WJC|www.wjgnet.com II February 26, 2016|Volume 8|Issue 2|
World Journal of Cardiology
Contents
Volume 8 Number 2 February 26, 2016
ABOUT COVER Editorial Board Member of World Journal of Cardiology, Nunzia R Petix, MD,
Doctor, Cardiology Department, S.Giuseppe Hospital, 50050 Empoli, Italy
AIM AND SCOPE World Journal of Cardiology (World J Cardiol, WJC, online ISSN 1949-8462, DOI: 10.4330)
is a peer-reviewed open access journal that aims to guide clinical practice and improve
diagnostic and therapeutic skills of clinicians.
WJC covers topics concerning arrhythmia, heart failure, vascular disease, stroke,
hypertension, prevention and epidemiology, dyslipidemia and metabolic disorders,
cardiac imaging, pediatrics, nursing, and health promotion. Priority publication will
be given to articles concerning diagnosis and treatment of cardiology diseases. The
following aspects are covered: Clinical diagnosis, laboratory diagnosis, differential
diagnosis, imaging tests, pathological diagnosis, molecular biological diagnosis,
immunological diagnosis, genetic diagnosis, functional diagnostics, and physical
diagnosis; and comprehensive therapy, drug therapy, surgical therapy, interventional
treatment, minimally invasive therapy, and robot-assisted therapy.
We encourage authors to submit their manuscripts to WJC. We will give priority to
manuscripts that are supported by major national and international foundations and
those that are of great basic and clinical significance.
INDEXING/ World Journal of Cardiology is now indexed in Emerging Sources Citation Index (Web of
ABSTRACTING Science), PubMed, and PubMed Central.
FLYLEAF I-IV Editorial Board
EDITORS FOR Responsible Assistant Editor: Xiang Li Responsible Science Editor: Shui Qiu
Responsible Electronic Editor: Ya-Jing Lu Proofing Editorial Office Director: Xiu-Xia Song
THIS ISSUE
Proofing Editor-in-Chief: Lian-Sheng Ma
NAME OF JOURNAL sion of Cardiology, Department of Medicine, Univer- PUBLICATION DATE
World Journal of Cardiology sity of California, Irvine, CA 92629, United States February 26, 2016
ISSN EDITORIAL OFFICE COPYRIGHT
ISSN 1949-8462 (online) Jin-Lei Wang, Director © 2016 Baishideng Publishing Group Inc. Articles
Xiu-Xia Song, Vice Director published by this Open-Access journal are distributed
LAUNCH DATE World Journal of Cardiology under the terms of the Creative Commons Attribution
December 31, 2009 Room 903, Building D, Ocean International Center, Non-commercial License, which permits use, distribution,
No. 62 Dongsihuan Zhonglu, Chaoyang District, and reproduction in any medium, provided the original
FREQUENCY Beijing 100025, China wotohrekr wisi sper ionp ceorlmy pciltiaendc, eth wei tuhs eth ies lnicoenn sceo.mmercial and is
Monthly Telephone: [phone]
Fax: [phone]
SPECIAL STATEMENT
E-mail: [email protected]
EDITORS-IN-CHIEF Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx All articles published in journals owned by the
Jian-Jun Li, MD, PhD, Professor, Center for Coro- http://www.wjgnet.com Baishideng Publishing Group (BPG) represent the
nary Artery Disease, Fu Wai Cardiovascular Hospital, views and opinions of their authors, and not the
Chinese Academy of Medical Science, Beijing 100037, views, opinions or policies of the BPG, except where
PUBLISHER
China otherwise explicitly indicated.
Baishideng Publishing Group Inc
Giuseppe De Luca, PhD, Assistant Professor, De- 8P2le2a6s aRnetgoenn, cCyA D 9r4iv5e8, 8, USA INSTRUCTIONS TO AUTHORS
partment of Cardiology, Piedmont University, Novara Telephone: [phone] Full instructions are available online at http://www.
28100, Italy Fax: [phone] wjgnet.com/bpg/g_info_20160116143427.htm.
E-mail: [email protected]
Nathan D Wong, FACC, FAHA, PhD, Director, Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx ONLINE SUBMISSION
Professor, Heart Disease Prevention Program, Divi- http://www.wjgnet.com http://www.wjgnet.com/esps/
WJC|www.wjgnet.com III February 26, 2016|Volume 8|Issue 2|
W J C World Journal of
Cardiology
Submit a Manuscript: http://www.wjgnet.com/esps/ World J Cardiol 2016 February 26; 8(2): 114-119
Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx ISSN 1949-8462 (online)
DOI: 10.4330/wjc.v8.i2.114 © 2016 Baishideng Publishing Group Inc. All rights reserved.
EDITORIAL
Omega 3 and atrial fibrillation: Where are we?
Annamaria Martino, Laura Pezzi, Roberta Magnano, Elisa Salustri, Maria Penco, Leonardo Calo’
Annamaria Martino, Leonardo Calo’, Division of Cardiology, fatty acids, at least in part mediated by anti-oxidant,
Policlinico Casilino, 00169 Rome, Italy anti-inflammatory and anti-fibrotic power, have been
widely proved. Effect of fish oil on atrial fibrillation,
Annamaria Martino, Department of Cardiovascular, Respiratory, both in primary and in secondary prevention and after
Nephrologic and Geriatrics Sciences, Umberto I Hospital, Sapienza
cardiac surgery, are controversial, mostly due to lack of
University, 00100 Rome, Italy
homogeneity between studies but also due to individual
variability in response to fatty acids administration.
Laura Pezzi, Roberta Magnano, Elisa Salustri, Maria Penco,
Inclusion of measurement of incorporation of fish oil
Department of Cardiology, University of l’Aquila, 67100 L’Aquila,
Italy into cell membranes, appears to be essential in future
studies, to assess their antiarrhythmic effect.
Author contributions: Martino A and Calo’ L designed the
research; Pezzi L, Magnano R and Salustri E performed the Key words: N-3 polyunsaturated fatty acids; Atrial
research; Martino A, Pezzi L, Magnano R and Salustri E analyzed fibrillation; Upstream therapy; Omega-3 index; Cardiac
the data; Martino A, Pezzi L, Magnano R, Salustri E, Penco M surgery
and Calo’ L wrote the paper.
© The Author(s) 2016. Published by Baishideng Publishing
Conflict-of-interest statement: The authors declare no conflict
Group Inc. All rights reserved.
of interest.
Open-Access: This article is an open-access article which was Core tip: Individual variability in response to fish oil
selected by an in-house editor and fully peer-reviewed by external administration, in terms of eicosapentaenoic and docosah-
reviewers. It is distributed in accordance with the Creative exaenoic acids in corporation into cell membranes, is
Commons Attribution Non Commercial (CC BY-NC 4.0) license, responsible for controversial results of n-3 poly-unsa-
which permits others to distribute, remix, adapt, build upon this turated fatty acids administration in patients suffering
work non-commercially, and license their derivative works on atrial fibrillation.
different terms, provided the original work is properly cited and
the use is non-commercial. See: http://creativecommons.org/
licenses/by-nc/4.0/
Martino A, Pezzi L, Magnano R, Salustri E, Penco M, Calo’ L.
Omega 3 and atrial fibrillation: Where are we? World J Cardiol
Correspondence to: Leonardo Calo’, MD, FESC, Division of
Cardiology, Policlinico Casilino, ASL Rome B, 00169 Rome, 2016; 8(2): 114-119 Available from: URL: http://www.wjgnet.
Italy. [email protected] com/1949-8462/full/v8/i2/114.htm DOI: http://dx.doi.org/10.4330/
Telephone: [phone] wjc.v8.i2.114
Fax: [phone]
Received: June 3, 2015
Peer-review started: June 3, 2015
INTRODUCTION
First decision: September 26, 2015
Revised: November 24, 2015 N-3 poly-unsaturated fatty acids (PUFA) anti-arrhythmic
Accepted: December 29, 2015
effects have been debated for several years, since their
Article in press: January 4, 2016
electrophysiological properties have been recognized.
Published online: February 26, 2016
Through direct interaction with membrane bound
proteins and thanks to incorporation into the phospholipid
bilayer, n-3 PUFA are well known to influence ion channels
and transmembrane pumps[1] to modulate signal transd-
Abstract
uction, protein trafficking and ion channels kinetic and to
Anti-arrhythmic properties of n-3 polyunsaturated regulate gene expression[2]. N-3 PUFA can also exert anti-
WJC|www.wjgnet.com 114 February 26, 2016|Volume 8|Issue 2|
Martino A et al. Effect of Omega 3 on atrial fibrillation
Table 1 Clinical studies investigating the effect of n-3 poly-unsaturated fatty acids on primary prevention for atrial fibrillation
Study design Population PUFA administration PUFA quantification AF diagnosis Results
Prospective cohort[5] 4815 individuals; age 72.8 Broiled/backed fish FFQ Annual ECG; hospital Lower AF risk of 31% with
yr; United States assessment. FU: 12 yr discharge diagnoses fish intake ≥ 5 times/wk
vs < 1/mo. P = 0.008
Prospective cohort[12] 2174 subjects; mean age: Serum EPA and DHA DHA, EPA serum National computerized Lower AF risk of 38% for
52.8 yr; Finland and dosage. FU: 17.7 yr dosage hospitalization registry higher DHA levels. P =
0.02
Prospective cohort[6] 3326 subjects; age: 74.1 yr; Serum EPA, DHA DHA, EPA serum Annual ECG; Lower AF risk for top vs
United States dosage dosage telephonic contact 2/yr; lowest quartile of PUFA/
hospitalizations DHA levels
Population study[7] 3242 subjects affected Previous PUFA intake FFQ AF episodes during Lower risk of AF with fish
by acute myocardial vs not. FU: 360 d hospitalization oil
infarction; age: 54.1 yr;
Italy
Prospective cohort[8] 47949 subjects; age: 46 yr; Fish-oil intake FFQ Danish national Higher AF risk for top vs
Denmark assessment. FU: 5.7 yr hospitalization registry lowest quintiles of fish
intake
Prospective cohort[9] 5184 subjects; age 67.4 yr; Fish-oil intake FFQ Two ECGs during No AF risk reduction in
the Netherland assessment. FU: 6.4 yr FU; clinical data from the highest tertile of fish
general practitioners intake
Prospective cohort[10] 44720 female; age: 63 yr; Fish intake assessment. FFQ ECG at baseline and No lower AF risk for
United States FU: 6 yr at the third and sixth higher fish intake
years
Prospective cohort[11] 4526 individuals; age: 62 Fish intake assessment. FFQ Two ECGs every 4 yr of No AF risk reduction in
yr; United States FU: 4 yr FU; hospitalizations the top vs the lowest tertile
of fish intake
Post-hoc analysis of a 5835 systolic heart failure-N-3 PUFAs 1 g/d vs No PUFA dosage ECG during FU visits No AF risk reduction with
RCT (Aleksova)[13] subjects placebo; FU 3.9 yr n-3 PUFA
FU: Follow-up; FFQ: Food frequency questionnaires; AF: Atrial fibrillation; EPA: Eicosapentaenoic acid; DHA: Docosahexaenoic acid; RCT: Randomized
controller trial; PUFA: Poly-unsaturated fatty acids.
inflammatory effects by antagonizing pro-inflammatory electrolyte disturbances and hemodynamic instability
prostaglandin formation[2], and exert anti-fibrotic effects[3], secondary to cardiac surgery, have also been also widely
as well as cardiac autonomic modulation[4]. investigated. An open label study[14] firstly observed a
In particular, the influence of n-3 PUFA on atrial fibrill- short-term n-3 PUFA administration-related decrease in
ation (AF) primary and secondary prevention, including POAF incidence after coronary artery bypass grafting.
post-operative AF (POAF) has also been the object of Two papers[15,16] also gained benefit from various fish-
numerous clinical studies. oil preparations and administration timings (Table 2). A
recent randomized-controlled trial (RCT)[17] also observed
N-3 PUFA in primary and secondary prevention and in reduction of POAF with n-3 PUFAs plus vitamins C and E
POAF administration in comparison to placebo, in 203 patients
Primary prevention: With regard to primary prevention scheduled for cardiac surgery. Further studies however,
of AF (Table 1), two studies involving elderly subjects[5,6] failed to prove both prevention of AF[18,19] and decrease
and one focusing on patients affected by acute myo- of inflammation[20] from higher serum levels of n-3 PUFA,
cardial infarction[7] proved n-3 PUFA to be protective eicosapentaenoic acid (EPA), or docosahexaenoic acid
against AF, while other studies[8-12], showed no benefit. (DHA), and from higher n3-PUFA atrial content[21,22].
The influence of various diet habits, including fish Recently, the multicenter double-blind RCT “OPERA”[23]
consumption[8,9], can possibly explain different results, showed no influence on POAF occurrence, from short-
as well as different methodologies used for assessment term n3-PUFA administration. The effect was unrelated
of fish intake and for AF diagnosis. In particular, po- to patients characteristics, kind of cardiac-surgery,
sitive studies, generally included elderly individuals[5-7], antiarrhythmic drugs, fish intake and serum n-3 PUFA. In
suggesting benefit from antifibrotic properties of fish- a substudy of this trial indeed[24], including 564 subjects
oil. However, a post-hoc analysis of the randomized receiving short-term PUFA or placebo before surgery,
controlled trial GISSI-HF[13] showed no effect of long- the risk of POAF was unrelated to fish oil concentrations
term PUFA administration on AF development in heart at enrollment and day of surgery. Interestingly, PUFA
failure patients, thus allowing no conclusions for the role increase, was characterized by significant inter-individual
of n-3 PUFA in AF primary prevention. variableness (0.7%-7.5% after 5 d of supplementation).
Finally, Metcalf et al[25], by using combined data from
Post-operative AF: The effect of n-3 PUFA in the previous RCTs, demonstrated less incidence of POAF
context of POAF, that is characterized by inflammation, among subject within the fourth quintile of red blood cell
WJC|www.wjgnet.com 115 February 26, 2016|Volume 8|Issue 2|