Skip to main content
Erschienen in: Heart and Vessels 6/2014

01.11.2014 | Original Article

Low serum eicosapentaenoic acid level is a risk for ventricular arrhythmia in patients with acute myocardial infarction: a possible link to J-waves

verfasst von: Tomohide Endo, Hirofumi Tomita, Takumi Higuma, Naoki Abe, Motoi Kushibiki, Shin Saitoh, Masahiro Yamada, Takashi Yokota, Takashi Echizen, Hiroaki Yokoyama, Shunta Tateyama, Akiko Suzuki, Yuji Ishida, Kazuo Murakami, Tomohiro Osanai, Ken Okumura

Erschienen in: Heart and Vessels | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Eicosapentaenoic acid (EPA) has antiarrhythmic effects. The J-wave on an electrocardiogram is associated with a high incidence of ventricular tachycardia/fibrillation (VT/VF). We evaluated relationships between EPA and J-waves, and their involvement in the occurrence of VT/VF in acute myocardial infarction (AMI). Two hundred consecutive patients undergoing successful percutaneous coronary intervention within 12 h after AMI onset were enrolled. Serum EPA level and J-waves at admission were evaluated. The patients were divided into two groups according to the optimal cutoff value (2.94) of serum EPA level (% of total fatty acids): LOW (<2.94, 61 ± 11 years, n = 103) and HIGH groups (≥2.94, 70 ± 13 years, n = 81). J-waves were observed more frequently in the LOW (36/103, 35 %) than in HIGH group (16/81, 20 %) (P = 0.020). The 30-day incidence of VT/VF including those occurring before admission was higher in the LOW (19.5 %) than in HIGH group (6.2 %) (P = 0.009). The patients with J-waves showed a higher incidence of VT/VF (23.1 %) than those without J-waves (9.9 %) (P = 0.019). Kaplan–Meier analysis showed that the highest incidence of VT/VF was observed in the LOW with J-wave group (27.8 %), followed by the LOW without J-wave (15.0 %), HIGH with J-wave (12.5 %), and HIGH without J-wave (4.6 %) (P = 0.013). Cox proportional hazard analysis revealed that Killip grade and low serum EPA level or presence of J-waves were significantly associated with the incidence of VT/VF. Low serum EPA level is a risk for incidence of VT/VF in the acute phase of myocardial infarction. Involvement of the J-wave and its possible link with EPA in the pathogenesis of ischemia-induced VT/VF are suggested.
Literatur
1.
Zurück zum Zitat Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, Kokubo Y, Tsugane S (2006) Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-based (JPHC) study cohort I. Circulation 113:195–202PubMedCrossRef Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, Kokubo Y, Tsugane S (2006) Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-based (JPHC) study cohort I. Circulation 113:195–202PubMedCrossRef
2.
Zurück zum Zitat Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico (1999) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 354:447–455CrossRef Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico (1999) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 354:447–455CrossRef
3.
Zurück zum Zitat Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, for the JELIS Investigators, Japan (2007) Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 369:1090–1098PubMedCrossRef Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, for the JELIS Investigators, Japan (2007) Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 369:1090–1098PubMedCrossRef
4.
Zurück zum Zitat Matsuzaki M, Yokoyama M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y, for the JELIS Investigators, Japan (2009) Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease. Circ J 73:1283–1290PubMedCrossRef Matsuzaki M, Yokoyama M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y, for the JELIS Investigators, Japan (2009) Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease. Circ J 73:1283–1290PubMedCrossRef
5.
Zurück zum Zitat Kinoshita I, Itoh K, Nishida-Nakai M, Hirota H, Otsuji S, Shibata N (1994) Antiarrhythmic effects of eicosapentaenoic acid during myocardial infarction-enhanced cardiac microsomal (Ca(2+)–Mg(2+))-ATPase activity. Jpn Circ J 58:903–912PubMedCrossRef Kinoshita I, Itoh K, Nishida-Nakai M, Hirota H, Otsuji S, Shibata N (1994) Antiarrhythmic effects of eicosapentaenoic acid during myocardial infarction-enhanced cardiac microsomal (Ca(2+)–Mg(2+))-ATPase activity. Jpn Circ J 58:903–912PubMedCrossRef
6.
Zurück zum Zitat Schrepf R, Limmert T, Claus Weber P, Theisen K, Sellmayer A (2004) Immediate effects of n-3 fatty acid infusion on the induction of sustained ventricular tachycardia. Lancet 363:1441–1442PubMedCrossRef Schrepf R, Limmert T, Claus Weber P, Theisen K, Sellmayer A (2004) Immediate effects of n-3 fatty acid infusion on the induction of sustained ventricular tachycardia. Lancet 363:1441–1442PubMedCrossRef
7.
Zurück zum Zitat Tomita T, Hata T, Takeuchi T, Oguchi Y, Okada A, Aizawa K, Koshikawa M, Otagiri K, Motoki H, Kasai H, Izawa A, Koyama J, Hongo M, Ikeda U (2012) High concentrations of omega-3 fatty acids are associated with the development of atrial fibrillation in the Japanese population. Heart Vessels 28:497–504PubMedCrossRef Tomita T, Hata T, Takeuchi T, Oguchi Y, Okada A, Aizawa K, Koshikawa M, Otagiri K, Motoki H, Kasai H, Izawa A, Koyama J, Hongo M, Ikeda U (2012) High concentrations of omega-3 fatty acids are associated with the development of atrial fibrillation in the Japanese population. Heart Vessels 28:497–504PubMedCrossRef
8.
Zurück zum Zitat Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O’Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J (2008) Sudden cardiac arrest associated with early repolarization. N Engl J Med 358:2016–2023PubMedCrossRef Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O’Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J (2008) Sudden cardiac arrest associated with early repolarization. N Engl J Med 358:2016–2023PubMedCrossRef
9.
Zurück zum Zitat Myojo T, Sato N, Matsuki M, Taniguchi O, Nakamura H, Hasebe N (2012) An acute myocardial infarction case that survived an out-of-hospital cardiac arrest in which prominent ischemic J waves were documented. Pacing Clin Electrophysiol 35:e27–e30PubMedCrossRef Myojo T, Sato N, Matsuki M, Taniguchi O, Nakamura H, Hasebe N (2012) An acute myocardial infarction case that survived an out-of-hospital cardiac arrest in which prominent ischemic J waves were documented. Pacing Clin Electrophysiol 35:e27–e30PubMedCrossRef
10.
Zurück zum Zitat Jastrzebski M, Kukla P (2009) Ischemic J wave: novel risk marker for ventricular fibrillation? Heart Rhythm 6:829–835PubMedCrossRef Jastrzebski M, Kukla P (2009) Ischemic J wave: novel risk marker for ventricular fibrillation? Heart Rhythm 6:829–835PubMedCrossRef
11.
Zurück zum Zitat Wilde AA (2012) “J-wave syndromes” bring the ATP-sensitive potassium channel back in the spotlight. Heart Rhythm 9:556–557PubMedCrossRef Wilde AA (2012) “J-wave syndromes” bring the ATP-sensitive potassium channel back in the spotlight. Heart Rhythm 9:556–557PubMedCrossRef
13.
Zurück zum Zitat Tsuburaya R, Yasuda S, Ito Y, Shiroto T, Gao JY, Ito K, Shimokawa H (2011) Eicosapentaenoic acid reduces ischemic ventricular fibrillation via altering monophasic action potential in pigs. J Mol Cell Cardiol 51:329–336PubMedCrossRef Tsuburaya R, Yasuda S, Ito Y, Shiroto T, Gao JY, Ito K, Shimokawa H (2011) Eicosapentaenoic acid reduces ischemic ventricular fibrillation via altering monophasic action potential in pigs. J Mol Cell Cardiol 51:329–336PubMedCrossRef
14.
Zurück zum Zitat Chen YC, Huang JH, Lin YK, Hsieh MH, Chen YJ (2013) Gender modulates the aging effects on different patterns of early repolarization. Heart Vessels. doi:10.1007/s00380-013-0352-z Chen YC, Huang JH, Lin YK, Hsieh MH, Chen YJ (2013) Gender modulates the aging effects on different patterns of early repolarization. Heart Vessels. doi:10.​1007/​s00380-013-0352-z
15.
Zurück zum Zitat 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 Vessels 26:145–152PubMedCrossRef 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 Vessels 26:145–152PubMedCrossRef
16.
Zurück zum Zitat Aarsetøy H, Pönitz V, Nilsen OB, Grundt H, Harris WS, Nilsen DW (2008) Low levels of cellular omega-3 increase the risk of ventricular fibrillation during the acute ischaemic phase of a myocardial infarction. Resuscitation 78:258–264PubMedCrossRef Aarsetøy H, Pönitz V, Nilsen OB, Grundt H, Harris WS, Nilsen DW (2008) Low levels of cellular omega-3 increase the risk of ventricular fibrillation during the acute ischaemic phase of a myocardial infarction. Resuscitation 78:258–264PubMedCrossRef
17.
Zurück zum Zitat Leaf A, Kang JX, Xiao YF, Billman GE (2003) Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 107:2646–2652PubMedCrossRef Leaf A, Kang JX, Xiao YF, Billman GE (2003) Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 107:2646–2652PubMedCrossRef
18.
Zurück zum Zitat Venkatesh N, Lamp ST, Weiss JN (1991) Sulfonylureas, ATP-sensitive K+ channels, and cellular K+ loss during hypoxia, ischemia, and metabolic inhibition in mammalian ventricle. Circ Res 69:623–637PubMedCrossRef Venkatesh N, Lamp ST, Weiss JN (1991) Sulfonylureas, ATP-sensitive K+ channels, and cellular K+ loss during hypoxia, ischemia, and metabolic inhibition in mammalian ventricle. Circ Res 69:623–637PubMedCrossRef
19.
Zurück zum Zitat Yan GX, Joshi A, Guo D, Hlaing T, Martin J, Xu X, Kowey PR (2004) Phase 2 reentry as a trigger to initiate ventricular fibrillation during early acute myocardial ischemia. Circulation 110:1036–1041PubMedCrossRef Yan GX, Joshi A, Guo D, Hlaing T, Martin J, Xu X, Kowey PR (2004) Phase 2 reentry as a trigger to initiate ventricular fibrillation during early acute myocardial ischemia. Circulation 110:1036–1041PubMedCrossRef
20.
Zurück zum Zitat Rudic B, Veltmann C, Kuntz E, Behnes M, Elmas E, Konrad T, Kuschyk J, Weiss C, Borggrefe M, Schimpf R (2012) Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction. Heart Rhythm 9:1295–1300PubMedCrossRef Rudic B, Veltmann C, Kuntz E, Behnes M, Elmas E, Konrad T, Kuschyk J, Weiss C, Borggrefe M, Schimpf R (2012) Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction. Heart Rhythm 9:1295–1300PubMedCrossRef
21.
Zurück zum Zitat Naruse Y, Tada H, Harimura Y, Hayashi M, Noguchi Y, Sato A, Yoshida K, Sekiguchi Y, Aonuma K (2012) Early repolarization is an independent predictor of occurrences of ventricular fibrillation in the very early phase of acute myocardial infarction. Circ Arrhythm Electrophysiol 5:506–513PubMedCrossRef Naruse Y, Tada H, Harimura Y, Hayashi M, Noguchi Y, Sato A, Yoshida K, Sekiguchi Y, Aonuma K (2012) Early repolarization is an independent predictor of occurrences of ventricular fibrillation in the very early phase of acute myocardial infarction. Circ Arrhythm Electrophysiol 5:506–513PubMedCrossRef
22.
Zurück zum Zitat Wilde AA, Janse MJ (1994) Electrophysiological effects of ATP sensitive potassium channel modulation: implications for arrhythmogenesis. Cardiovasc Res 28:16–24PubMedCrossRef Wilde AA, Janse MJ (1994) Electrophysiological effects of ATP sensitive potassium channel modulation: implications for arrhythmogenesis. Cardiovasc Res 28:16–24PubMedCrossRef
24.
Zurück zum Zitat Nakayama M, Sato M, Kitazawa H, Saito A, Ikeda Y, Fujita S, Fuse K, Takahashi M, Takarada K, Oguro T, Matsushita H, Okabe M, Yamashina A, Aizawa Y (2013) J-waves in patients with an acute ST-elevation myocardial infarction who underwent successful percutaneous coronary intervention: prevalence, pathogenesis, and clinical implication. Europace 15:109–115PubMedCrossRef Nakayama M, Sato M, Kitazawa H, Saito A, Ikeda Y, Fujita S, Fuse K, Takahashi M, Takarada K, Oguro T, Matsushita H, Okabe M, Yamashina A, Aizawa Y (2013) J-waves in patients with an acute ST-elevation myocardial infarction who underwent successful percutaneous coronary intervention: prevalence, pathogenesis, and clinical implication. Europace 15:109–115PubMedCrossRef
25.
Zurück zum Zitat Patel RB, Ng J, Reddy V, Chokshi M, Parikh K, Subacius H, Alsheikh-Ali AA, Nguyen T, Link MS, Goldberger JJ, Ilkhanoff L, Kadish AH (2010) Early repolarization associated with ventricular arrhythmias in patients with chronic coronary artery disease. Circ Arrhythm Electrophysiol 3:489–495PubMedCrossRef Patel RB, Ng J, Reddy V, Chokshi M, Parikh K, Subacius H, Alsheikh-Ali AA, Nguyen T, Link MS, Goldberger JJ, Ilkhanoff L, Kadish AH (2010) Early repolarization associated with ventricular arrhythmias in patients with chronic coronary artery disease. Circ Arrhythm Electrophysiol 3:489–495PubMedCrossRef
Metadaten
Titel
Low serum eicosapentaenoic acid level is a risk for ventricular arrhythmia in patients with acute myocardial infarction: a possible link to J-waves
verfasst von
Tomohide Endo
Hirofumi Tomita
Takumi Higuma
Naoki Abe
Motoi Kushibiki
Shin Saitoh
Masahiro Yamada
Takashi Yokota
Takashi Echizen
Hiroaki Yokoyama
Shunta Tateyama
Akiko Suzuki
Yuji Ishida
Kazuo Murakami
Tomohiro Osanai
Ken Okumura
Publikationsdatum
01.11.2014
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 6/2014
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-013-0435-x

Weitere Artikel der Ausgabe 6/2014

Heart and Vessels 6/2014 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.