Heart Failure Clinical Trial
Official title:
Salutary Effects of Dietary Supplementation With OMEGA 3 on Exercise Performance and Endothelial Function in Patients With Congestive Heart Failure. A Matter of Lipid Oxidation ?
A diet rich in Omega-3 (fish oil) reduces plasma triglycerides and the risk for ischemic
heart disease. Recently, a large trial evaluating treatment with Omega 3 in heart failure
patients suggested that omega 3 may lower the risk of death from CHF. The mechanism of this
potential benefit is not well understood.
Methods:
Forty patients will be enrolled in the study. Twenty patients will receive Omega 3 (lovaza 4
gm a day) and 20 patients will receive placebo. All subjects will have assessment of their
exercise capacity and blood vessel function before and after an 8 week treatment period.
About 4 table spoons of blood will be drawn throughout the study.
Expected results:
The investigators believe that omega 3 may improve the ability to exercise and improve blood
vessel function.
A diet rich in Omega-3 polyunsaturated fatty acids Omega 3 reduces plasma triglycerides and
the risk for ischemic heart disease1, and may exert direct antiarrhythmic effect on the
myocardium 2-9. A post-hoc analysis of the GISSI-Prevenzione trial demonstrated a reduction
in all-cause and sudden mortality in a subgroup of nearly 2000 post-infarction patients with
left ventricular dysfunction 10. This provocative finding has now been prospectively studied
in a large-scale, randomized, double-blind study designed to investigate the effects of
Omega 3 on mortality and morbidity in patients with symptomatic heart failure (the GISSI
Heart Failure project). The results of the GISSI-HF trial demonstrate that 1 g per day of
Omega 3 is associated with 9% reduction in mortality and cardiovascular admissions in
patients with predominantly systolic heart failure, when added to optimal medical therapy11.
The mechanism(s) underlying these beneficial effects remains to be elucidated and will be
critical in fully exhausting the therapeutic benefits of Omega 3 in CHF. We have recently
demonstrated that lipid oxidation during acute exercise is altered in patients with CHF 12
and that the degree of this alteration carries prognostic significance. It is conceivable
that Omega 3 modulates lipid oxidation during exercise and thereby favorably effect outcome.
Accordingly we propose to study the effect of Omega 3 on lipid oxidation during exercise in
CHF. We will further examine VO2 and endothelial function at present the principal surrogate
markers for survival in CHF 13.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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