ω-3 polyunsaturated fatty acids and the cardiovascular system
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- Kryzhanovskii, S.A. & Vititnova, M.B. Hum Physiol (2009) 35: 491. doi:10.1134/S036211970904015X
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ω-3 polyunsaturated fatty acids (PUFAs) (alpha-linolenic, eicosapentaenoic, and decosahexaenoic acids) are classified with essential fatty acids and are structural components of the phospholipid bilayer of cell membranes. ω-3 PUFAs incorporated into the phospholipid domain of cell membranes are metabolized to prostaglandins and thromboxanes (PGI3, PGE3, TxA, etc.), which significantly differ in biological activity from those formed in the arachidonic acid cascade (PGI2, PGE2, TxA2, etc.) and to which the antiaggregatory, antiatherogenic, and vasodilating effects of ω-3 PUFAs can largely be attributed. In addition, ω-3 PUFAs incorporated into cardiomyocyte cell membranes considerably modify the functional activity of transmembrane voltage-gated ion channels by causing a dose-dependent inhibition of the outward transmembrane sodium current, slowing down the work of transmembrane voltage-gated slow L-type calcium channels, and partially blocking the efflux of potassium ions from cardiomyocytes, thus showing the properties of class I, III, and IV antiarrhythmic drugs according to the Vaughnan Williams classification. Several clinical trials have supported experimental data that ω-3 PUFAs have membrane-stabilizing (antiarrhythmogenic) effects. For example, in the GISSI-Prevenzione trial, a large-scale, randomized, placebo-controlled study conducted in more than 9.5 thousand patients with left ventricular systolic dysfunction after myocardial infarction, ω-3 PUFA regular consumption significantly reduced the risk of sudden cardiac death by more than 50% in these patients. In our review, the mechanisms underlying the membrane-stabilizing, antiaggregatory, antiatherogenic, and vasodilating effects of ω-3 PUFAs and the clinical effectiveness of ω-3 PUFAs have been analyzed in terms of evidencebased pharmacology.