Heart rate variability and n-3 polyunsaturated fatty acids in patients with diabetes mellitus

Low heart rate variability (HRV) is independently associated with increased risk of sudden cardiac death (SCD) and all cardiac death in haemodialysis patients. Long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) may exert anti-arrhythmic effects. This study aimed to investigate relationships between dialysis, sleep and 24 h HRV and LC n-3 PUFA status in patients who have recently commenced haemodialysis. A cross-sectional study was conducted in adults aged 40–80 with chronic kidney disease (CKD) stage 5 (n = 45, mean age 58, SD 9, 20 females and 25 males, 39% with type 2 diabetes). Pre-dialysis blood samples were taken to measure erythrocyte and plasma fatty acid composition (wt % fatty acids). Mean erythrocyte omega-3 index was not associated with HRV following adjustment for age, BMI and use of β-blocker medication. Higher ratios of erythrocyte eicosapentaenoic acid (EPA) to docosahexaenoic acid (DHA) were associated with lower 24 h vagally-mediated beat-to-beat HRV parameters. Higher plasma EPA and docosapentaenoic acid (DPAn-3) were also associated with lower sleep-time and 24 h beat-to-beat variability. In contrast, higher plasma EPA was significantly related to higher overall and longer phase components of 24 h HRV. Further investigation is required to investigate whether patients commencing haemodialysis may have compromised conversion of EPA to DHA, which may impair vagally-mediated regulation of cardiac autonomic function, increasing risk of SCD.

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Heart Rate Variability and Cardiovascular Tests in Young Patients with Diabetes Mellitus Type 1

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem.1999.12.3.423 ◽

1999 ◽

Vol 12 (3) ◽

Cited By ~ 15

Author(s):

K. Javorka ◽

J. Javorková ◽

M. Petrášková ◽

I. Tonhajzerová ◽

J. Buchanec ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Rate ◽

Heart Rate Variability ◽

Young Patients ◽

Diabetes Mellitus Type 1 ◽

Diabetes Mellitus Type ◽

Patients With Diabetes ◽

Cardiovascular Tests

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Effects of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability and Heart Rate in Patients on Chronic Dialysis: A Randomized Controlled Trial

Nutrients ◽

10.3390/nu10091313 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1313 ◽

Cited By ~ 6

Author(s):

Jesper Rantanen ◽

Sam Riahi ◽

Martin Johansen ◽

Erik Schmidt ◽

Jeppe Christensen

Keyword(s):

Fatty Acids ◽

Heart Rate ◽

Heart Rate Variability ◽

Sudden Cardiac Death ◽

Polyunsaturated Fatty Acids ◽

Cardiac Death ◽

Controlled Trial ◽

Chronic Dialysis ◽

Dialysis Vintage ◽

The Mean

Marine n-3 polyunsaturated fatty acids (PUFA) may improve autonomic dysfunction, as indicated by an increase in heart rate variability (HRV) and reduce the risk of sudden cardiac death. Hence, the aim of this study was to investigate the effects of marine n-3 PUFA on 24-h HRV in patients on chronic dialysis, who have a high risk of sudden cardiac death. Between June 2014 and March 2016, 112 patients on chronic dialysis from Denmark were allocated to a daily supplement of 2 g marine n-3 PUFA or control for three months in a randomized, double-blinded, controlled trial. A 48-h Holter monitoring was performed and mean 24-h HRV indices for the two days were available in 85 patients. The mean age was 62.3 years (SD: 14.3) and median dialysis vintage was 1.7 years (IQR: 0.5, 6.4). Within-group and between-group changes in outcome were evaluated by a paired and two sample t-test, respectively. Marine n-3 PUFA did not change the primary endpoint SDNN (SD of all RR-intervals) reflecting overall HRV, but other HRV indices increased and the mean RR-interval increased significantly, corresponding to a decrease in heart rate by 2.5 beats per minute (p = 0.04). In conclusion, marine n-3 PUFA did not change SDNN, but the mean heart rate was significantly reduced and changes in other HRV-indices were also observed, indicating an increase in vagal modulation that might be protective against malignant ventricular arrhythmias.

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