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Heart and Vessels

, Volume 27, Issue 6, pp 576–584 | Cite as

Cross-sectional relationship of a Mediterranean type diet to diastolic heart function in chronic heart failure patients

  • Christina Chrysohoou
  • Christos Pitsavos
  • George Metallinos
  • Christos Antoniou
  • Evaggelos Oikonomou
  • Iason Kotroyiannis
  • Apostolis Tsantilas
  • George Tsitsinakis
  • Dimitris Tousoulis
  • Demosthenes B. Panagiotakos
  • Christodoulos Stefanadis
Original Article

Abstract

Systolic and diastolic functions of both ventricles play a crucial role in the progression of chronic heart failure (CHF). As data about the role of dietary habits in ventricular dysfunction are lacking, we aimed to evaluate the relationship between biventricular diastolic and systolic function and dietary habits in patients with CHF. During 2007, 372 consecutive CHF patients were enrolled. Biventricular systolic and diastolic function was evaluated through echocardiography. Dietary habits were recorded using a food frequency questionnaire, and adherence to a Mediterranean diet was evaluated using the MedDietScore. The MedDietScore was positively correlated with log Smv, left atrial EF and V p, and inversely correlated with log EA and log Emv/Amv levels (p < 0.05). After adjusting for potential confounders, only log E/A levels were inversely associated with the MedDietScore (p < 0.05). Following analysis per specific aliments, the log E/A ratio was inversely associated with fish intake and olive oil use; the log Emv/Amv ratio was inversely associated with fish intake; log Stv was positively associated with fish, olive oil and pasta intake; log LAKE was positively associated with olive oil use and alcohol drinking (all p < 0.05). This study demonstrated, in a cross-sectional design, a potential beneficial effect of a Mediterranean diet on biventricular systolic and diastolic function.

Keywords

Diastolic function Mediterranean diet Echocardiography Tissue Doppler imaging 

Notes

Acknowledgments

The authors would like to thank Ms Christina-Maria Kastorini, MSc, and Ms S. Paspaliari, MSc, for their assistance in dietary data selection.

Conflict of interest

None declared.

References

  1. 1.
    Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Klapholz M, Moser DK, Rogers JG, Starling RC, Stevenson WG, Tang WHW, Teerlink JR, Walsh MN (2010) Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 16:475–539CrossRefGoogle Scholar
  2. 2.
    Keys A, Mienotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Keys MH, Kromhout D, Nedeljkovic S, Punsar S, Seccareccia F, Toshima H (1986) The diet and 15-year death rate in the Seven Countries Study. Am J Epidemiol 124:903–915PubMedGoogle Scholar
  3. 3.
    De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N (1999) Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 99:779–785PubMedCrossRefGoogle Scholar
  4. 4.
    Panagiotakos DB, Arapi S, Pitsavos C, Antonoulas A, Mantas Y, Zombolos S, Stefanadis C (2006) The relationship between adherence to the Mediterranean diet and the severity and short-term prognosis of acute coronary syndromes (ACS): The Greek Study of ACS (The GREECS). Nutrition 22:722–730PubMedCrossRefGoogle Scholar
  5. 5.
    Carter SJ, Roberts MB, Salter J, Eaton CB (2010) Relationship between Mediterranean Diet Score and atherothrombotic risk: findings from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Atherosclerosis 210:630–636PubMedCrossRefGoogle Scholar
  6. 6.
    Chrysohoou C, Panagiotakos DB, Pitsavos C, Das UN, Stefanadis C (2004) Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults. The ATTICA Study. J Am Coll Cardiol 44:152–158PubMedCrossRefGoogle Scholar
  7. 7.
    Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446PubMedCrossRefGoogle Scholar
  8. 8.
    Simopoulos AP (2009) Omega-6/omega-3 essential fatty acids: biological effects. World Rev Nutr Diet 99:1–16PubMedCrossRefGoogle Scholar
  9. 9.
    Catapano G, Pedone C, Nunziata E, Zizzo A, Passantino A, Incalzi RA (2008) Nutrient intake and serum cytokine pattern in elderly people with heart failure. Eur J Heart Fail 10:428–434PubMedCrossRefGoogle Scholar
  10. 10.
    Gissi-HF Investigators, Tavazzi L, Maggioni AP, Marchioli R, Barlera S, Franzosi MG, Latini R, Lucci D, Nicolosi GL, Porcu M, Tognoni G (2008) Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet 372:1223–1230Google Scholar
  11. 11.
    Mozaffarian D, Geelen A, Brouwer IA, Geleijnse JM, Zock PL, Katan MB (2005) Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials. Circulation 112:1945–1952PubMedCrossRefGoogle Scholar
  12. 12.
    Appleton CP, Hatle LK, Popp RL (1998) Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 12:426–440CrossRefGoogle Scholar
  13. 13.
    Gunes Y, Guntekin U, Tuncer M, Sahin M (2009) Improved left and right ventricular functions with trimetazidine in patients with heart failure: a tissue Doppler study. Heart Vessels 24:277–282PubMedCrossRefGoogle Scholar
  14. 14.
    Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41PubMedCrossRefGoogle Scholar
  15. 15.
    Tyrovolas S, Pounis G, Bountziouka V, Polychronopoulos E, Panagiotakos DB (2010) Repeatability and validation of a short, semi-quantitative food frequency questionnaire designed for older adults living in Mediterranean areas: the MEDIS-FFQ. J Nutr Elder 29:311–324PubMedCrossRefGoogle Scholar
  16. 16.
    Panagiotakos DB, Pitsavos C, Stefanadis C (2006) Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 16:559–568PubMedCrossRefGoogle Scholar
  17. 17.
    Dardas PS, Pitsis AA, Tsikaderis DD, Mezilis NE, Geleris PN, Boudoulas HK (2004) Left atrial volumes function and work before and after mitral valve repair in chronic mitral regurgitation. J Heart Valve Dis 13:27–32PubMedGoogle Scholar
  18. 18.
    Garcia MJ, Smedira NG, Greenberg NL, Main M, Firstenberg MS, Odabashian J (2000) Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation. J Am Coll Cardiol 35:201–208PubMedCrossRefGoogle Scholar
  19. 19.
    Ueeda M, Doumei T, Takaya Y, Ohnishi N, Takaishi A, Hirohata S, Miyoshi T, Shinohata R, Usui S, Kusachi S (2011) Association of serum levels of arachidonic acid and eicosapentaenoic acid with prevalence of major adverse cardiac events after acute myocardial infarction. Heart Vessel 26:145–152CrossRefGoogle Scholar
  20. 20.
    Chrysohoou C, Pitsavos C, Barbetseas J, Kotroyiannis I, Brili S, Vasiliadou K, Papadimitriou L, Stefanadis C (2009) Chronic systemic inflammation accompanies impaired ventricular diastolic function, detected by Doppler imaging, in patients with newly diagnosed systolic heart failure (Hellenic Heart Failure Study). Heart Vessels 24:22–26PubMedCrossRefGoogle Scholar
  21. 21.
    Yan AT, Yan RT, Cushman M, Redheuil A, Tracy RP, Arnett DK, Rosen BD, McClelland RL, Bluemke DA, Lima JA (2010) Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis. Eur Heart J 31:875–882PubMedCrossRefGoogle Scholar
  22. 22.
    Hughes CM, Woodside JV, McGartland C, Roberts MJ, Nicholls DP, McKeown PP (2010) Nutritional intake and oxidative stress in chronic heart failure. Nutr Metab Cardiovasc Dis. doi: 10.1016/j.numecd.2010.08.006
  23. 23.
    Duda MK, O’Shea KM, Lei B, Barrows BR, Azimzadeh AM, McElfresh TE, Hoit BD, Kop WJ, Stanley WC (2007) Dietary supplementation with omega-3 PUFA increases adiponectin and attenuates ventricular remodeling and dysfunction with pressure overload. Cardiovasc Res 76:303–310PubMedCrossRefGoogle Scholar
  24. 24.
    Wada H, Shinjo D, Kameda S, Ono K, Satoh N, Morimoto T, Osakada G, Nakano T, Fujita M, Shimatsu A, Hasegawa K (2010) Transmitral E/A ratio decreases in association with abdominal fat accumulation in patients with impaired glucose tolerance or mild diabetes without left ventricular hypertrophy. Heart Vessels 25:45–50PubMedCrossRefGoogle Scholar
  25. 25.
    Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: part I: diagnosis, prognosis and measurements of diastolic function. Circulation 105:1387–1393PubMedCrossRefGoogle Scholar
  26. 26.
    Yu CM, Sanderson JE, Marwick TH, Oh JK (2007) Tissue Doppler imaging. A new prognosticator for cardiovascular diseases. J Am Coll Cardiol 49:1903–1914PubMedCrossRefGoogle Scholar
  27. 27.
    Chrysohoou C, Antoniou CK, Kotrogiannis I, Metallinos G, Aggelis A, Andreou I, Brili S, Pitsavos C, Stefanadis C (2011) The role of right ventricular systolic function on long-term outcome in patients with newly diagnosed systolic heart failure. Circ J 75:2176–2181Google Scholar
  28. 28.
    Chrysohoou C, Panagiotakos DB, Pitsavos C, Skoumas J, Krinos X, Chloptsios Y, Nikolaou V, Stefanadis C (2007) Long-term fish consumption is associated with protection against arrhythmia in healthy persons in a Mediterranean region—the ATTICA study. Am J Clin Nutr 85:1385–1391PubMedGoogle Scholar
  29. 29.
    Shah KB, Duda MK, O’Shea KM, Sparagna GC, Chess DJ, Khairallah RJ, Robillard-Frayne I, Xu W, Murphy RC, Des Rosiers C, Stanley WC (2009) The cardioprotective effects of fish oil during pressure overload are blocked by high fat intake: role of cardiac phospholipid remodeling. Hypertension 54:605–611PubMedCrossRefGoogle Scholar
  30. 30.
    Meluzin J, Spinarová L, Hude P, Krejcí J, Dusek L, Vítovec J, Panovsky R (2005) Combined right ventricular systolic and diastolic dysfunction represents a strong determinant of poor prognosis in patients with symptomatic heart failure. Int J Cardiol 105:164–173PubMedCrossRefGoogle Scholar
  31. 31.
    Kjaergaard J, Akkan D, Iversen KK, Kober L, Torp-Pedersen C, Hassager C (2007) Right ventricular dysfunction as an independent predictor of short and long term mortality in patients with heart failure. Eur J Heart Fail 9:610–616PubMedCrossRefGoogle Scholar
  32. 32.
    Chrysohoou C, Kastorini CM, Panagiotakos D, Aggelopoulos P, Tsiachris D, Pitsavos C, Stefanadis C (2009) Exclusive olive oil consumption is associated with lower likelihood of developing left ventricular systolic dysfunction in acute coronary syndrome patients: The Hellenic Heart Failure Study. Ann Nutr Metab 56:9–15PubMedCrossRefGoogle Scholar
  33. 33.
    Chrysohoou C, Panagiotakos DB, Aggelopoulos P, Kastorini CM, Kehagia I, Pitsavos C, Stefanadis C (2010) The Mediterranean diet contributes to the preservation of left ventricular systolic function and to the long-term favourable prognosis of patients who have had an acute coronary event. Am J Clin Nutr 92:47–54PubMedCrossRefGoogle Scholar
  34. 34.
    Andreadou I, Iliodromitis EK, Mikros E, Constantinou M, Agalias A, Magiatis P, Skaltsounis AL, Kamber E, Tsantili-Kakoulidou A, Kremastinos D (2006) The olive constituent oleuropein exhibits anti-ischemic, anti-oxidative and hypolipidemic effects in anesthetized rabbits. J Nutr 136:2213–2219PubMedGoogle Scholar
  35. 35.
    Chrysohoou C, Pitsavos C, Barbetseas J, Brili S, Kotroyiannis I, Papademetriou L, Metallinos G, Skoumas J, Tentolouris C, Stefanadis C (2008) Serum uric acid levels correlate with left atrial function and systolic right ventricular function in patients with newly diagnosed heart failure: the Hellenic heart failure study. Congest Heart Fail 14:229–233PubMedCrossRefGoogle Scholar
  36. 36.
    Prioli A, Marino P, Lanzoni L, Zardini P (1998) Increasing degrees of left ventricular filling impairment modulates left atrial function in humans. Am J Cardiol 82:756–761PubMedCrossRefGoogle Scholar
  37. 37.
    Walsh CR, Larson MG, Evans JC, Djousse L, Ellison RC, Vasan RS, Levy D (2002) Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med 136:181–191PubMedGoogle Scholar
  38. 38.
    Heart Failure Society of America (2010) Nonpharmacologic management and health care maintenance in patients with chronic heart failure. J Card Fail 16:e61–e72CrossRefGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  • Christina Chrysohoou
    • 1
  • Christos Pitsavos
    • 1
  • George Metallinos
    • 1
  • Christos Antoniou
    • 1
  • Evaggelos Oikonomou
    • 1
  • Iason Kotroyiannis
    • 1
  • Apostolis Tsantilas
    • 1
  • George Tsitsinakis
    • 1
  • Dimitris Tousoulis
    • 1
  • Demosthenes B. Panagiotakos
    • 2
  • Christodoulos Stefanadis
    • 1
  1. 1.First Cardiology Clinic, School of MedicineUniversity of AthensAthensGreece
  2. 2.Department of Nutrition and DieteticsHarokopio UniversityAthensGreece

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