PT - JOURNAL ARTICLE AU - H Rupp AU - T P Rupp AU - P Alter AU - B Maisch TI - Inverse shift in serum polyunsaturated and monounsaturated fatty acids is associated with adverse dilatation of the heart AID - 10.1136/hrt.2009.176560 DP - 2010 Apr 01 TA - Heart PG - 595--598 VI - 96 IP - 8 4099 - http://heart.bmj.com/content/96/8/595.short 4100 - http://heart.bmj.com/content/96/8/595.full SO - Heart2010 Apr 01; 96 AB - Background Cardiac dilatation is associated with impaired pump function, progression of heart failure and electrical instability. Risk of sudden death is associated with a low blood level of n-3 polyunsaturated fatty acids.Objective The hypothesis was, therefore, addressed that left ventricular dilatation as assessed by echocardiography is associated with a reduced serum polyunsaturated fatty acid level.Methods Fatty acids were determined with gas chromatography/mass spectrometry in serum of 308 patients with dilative heart failure unrelated to myocardial infarction (age 48 (SD12) years, NYHA class 2.2 (0.6), ejection fraction 31% (10%)).Results The extent of left ventricular dilatation as assessed by left ventricular end-diastolic diameter was associated with a reduction of both n-3 and n-6 polyunsaturated fatty acids. The n-3 docosahexaenoic acid (1.0% (0.5%) vs 1.3% (0.6%), p<0.001) and the n-6 arachidonic acid (4.6% (1.8%) vs 5.2% (1.9%), p<0.01) were reduced in patients with left ventricular dilatation (end-diastolic diameter, 68–90 mm, upper tertile vs 48–61 mm, lower tertile). By contrast, monounsaturated fatty acids were increased (the n-9 oleic acid 26.1% (4.8%) vs 23.9% (4.8%), p<0.01). A low docosahexaenoic acid (0.01–0.9%, lower tertile vs 1.4–3.1%, upper tertile) was associated with greater left ventricular dilatation (end-diastolic diameter, 67 (8) vs 63 (7) mm, p<0.001). The cut-off for the absence of severe dilatation (end-diastolic diameter >70 mm) was set at >1.24% docosahexaenoic acid. In our sample, the negative-predictive value for severe dilatation was 91% and sensitivity was 84%.Conclusions Docosahexaenoic acid provides a new sensitive biomarker for monitoring and detecting severe left ventricular dilatation in heart failure patients.