title: Fatty acid composition in chronic heart failure: low circulating levels of eicosatetraenoic acid and high levels of vaccenic acid are associated with disease severity and mortality.
abstract: OBJECTIVE
  Free fatty acids (FFAs) are the major energy sources of the heart, and fatty acids (FAs) are active components of biological membranes. Data indicate that levels of FAs and their composition may influence myocardial function and inflammation. The aim of this study was to investigate whether total levels and composition of FAs and FFAs in plasma are altered in clinical heart failure (HF) and whether any alterations in these parameters are correlated with the severity of HF.
  
  
  METHODS
  Plasma from 183 patients with stable HF was compared with plasma from 44 healthy control subjects.
  
  
  RESULTS
  Our main findings are as follows: (i) patients with HF had decreased levels of several lipid parameters and increased levels of FFAs in plasma, compared with controls, which were significantly correlated with clinical disease severity. (ii) Patients with HF also had a decreased proportion in the plasma of several n-3 polyunsaturated FAs, an increased proportion of several monounsaturated FAs, and a decreased proportion of some readily oxidized long-chain saturated FAs. (iii) These changes in FA composition were significantly associated with functional class, impaired cardiac function (i.e., decreased cardiac index and increased plasma N-terminal pro-B-type natriuretic peptide levels) and enhanced systemic inflammation (i.e., increased high-sensitivity C-reactive protein levels). (iv) Low levels of C20:4n-3 (eicosatetraenoic acid) and in particular high levels of C18:1n-7 (vaccenic acid) were significantly associated with total mortality in this HF population.
  
  
  CONCLUSIONS
  Our data demonstrate that patients with HF are characterized by a certain FA phenotype and may support a link between disturbed FA composition and the progression of HF.
authors.affiliation: Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. erik.oie@medisin.uio.no
authors.forename: E
authors.initials: E
authors.lastname: Øie
authors.forename: T
authors.initials: T
authors.lastname: Ueland
authors.forename: C P
authors.initials: CP
authors.lastname: Dahl
authors.forename: P
authors.initials: P
authors.lastname: Bohov
authors.forename: C
authors.initials: C
authors.lastname: Berge
authors.forename: A
authors.initials: A
authors.lastname: Yndestad
authors.forename: L
authors.initials: L
authors.lastname: Gullestad
authors.forename: P
authors.initials: P
authors.lastname: Aukrust
authors.forename: R K
authors.initials: RK
authors.lastname: Berge
mesh_terms: D000328:Adult; D000368:Aged; D001095:Arachidonic Acids / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009829:Oleic Acids / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
chemical_list: D001095:Arachidonic Acids; D015415:Biomarkers; D005231:Fatty Acids, Unsaturated; D009829:Oleic Acids; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; C050413:11-octadecenoic acid