rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2020-05-01rpcardio-2231Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИThe Value of Omega-3 Fatty Acids in the Prevention of Heart Rhythm DisordersЗначение омега-3 полиненасыщенных жирных кислот в профилактике нарушений сердечного ритмаПодзолковВ. И.PodzolkovV. I.

Подзолков Валерий Иванович - доктор медицинских наук, профессор, заведующий кафедрой факультетской терапии №2, директор клиники факультетской терапии №2, Сеченовский Университет.

119991, Москва, ул. Трубецкая, 8, стр. 2.

Valery I. Podzolkov - MD, PhD, Professor, Head of Chair of Faculty Therapy №2, Director of the Therapeutic Clinic, University Clinical Hospital №4, Sechenov University.

Trubetskaya ul. 8-2, Moscow, 119991.

ТарзимановаА. И.TarzimanovaA. I.

Тарзиманова Аида Ильгизовна - доктор медицинских наук, профессор, кафедра факультетской терапии №2, Сеченовский Университет.

119991, Москва, ул. Трубецкая, 8, стр. 2.

Aida I. Tarzimanova - MD, PhD, Professor, Chair of Faculty Therapy №2, Sechenov University.

Trubetskaya ul. 8-2, Moscow, 119991.

tarzimanova@mail.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202004072020163498502Copyright © Podzolkov V.I., Tarzimanova A.I., 20202020Подзолков В.И., Тарзиманова А.И.Podzolkov V.I., Tarzimanova A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2231

One of the trends in modern cardiology is the use of omega-3 polyunsaturated fatty acids (ω-3 PUFA) in the prevention of heart rhythm disorders and the prevention of sudden cardiac death. In experimental studies, it was found that ω-3 PUFAs have a variety of pleiotropic effects: they reduce the formation of oxygen radicals, reduce reperfusion complications, reduce the level of thromboxane and platelet aggregation, and improve endothelial function. The ability of ω-3 PUFA to have an anti-inflammatory effect, which includes the inhibition of leukocyte chemotaxis, the expression of adhesion molecules, the formation of eicosanoids and biologically active substances with powerful anti-inflammatory properties. One of the most significant effects of ω-3 PUFA can be considered their anti-atherogenic effect. Antiarrhythmic properties of го-3 PUFA are associated with the effect on the ion channels of cardiomyocytes, they are able to activate "slow" calcium channels, increase the activity of Ca2+/Mg2+-ATPase and reduce the work of sodium channels. In animal experiments, it has been shown that in conditions of ischemia or adrenergic stimulation, ω-3 PUFA stabilizes the cardiomyocyte membrane, can increase the duration of the effective refractory period, and prevent the development of various heart rhythm disorders. Clinical studies have shown that the administration of ω-3 PUFA in addition to standard treatment reduces the risk of new cases of atrial fibrillation, ventricular arrhythmias and sudden cardiac death.

Одним из трендов современной кардиологии является применение препаратов омега-3 полиненасыщенных жирных кислот (ω-3 ПНЖК) в профилактике нарушений сердечного ритма и предотвращении внезапной сердечной смерти. В экспериментальных исследованиях установлено, что ω-3 ПНЖК обладают разнообразными плейотропными эффектами: снижают образование кислородных радикалов, уменьшают реперфузионные осложнения, снижают уровень тромбоксана и агрегацию тромбоцитов, улучшают эндотелиальную функцию. Доказана способность ω-3 ПНЖК оказывать противовоспалительное действие, которое включает в себя ингибирование хемотаксиса лейкоцитов, экспрессии молекул адгезии, образование эйкозаноидов и биологически активных веществ, обладающих мощными противовоспалительными свойствами. Одним из наиболее значимых эффектов ω-3 ПНЖК можно считать их антиатерогенное действие. Антиаритмические свойства ω-3 ПНЖК связаны с воздействием на ионные каналы кардиомиоцитов, они способны активировать «медленные» кальциевые каналы, повышать активность Ca2+/Mg2+-АТФазы и уменьшать работу натриевых каналов. В экспериментах на животных было показано, что в условиях ишемии или адренергической стимуляции го-3 ПНЖК стабилизируют мембрану кардиомиоцитов, способны увеличивать длительность эффективного рефрактерного периода и предупреждать развитие различных нарушений сердечного ритма. Проведенные клинические исследования доказывают, что назначение ω-3 ПНЖК в дополнение к стандартному лечению способствует снижению риска развития новых случаев фибрилляции предсердий, желудочковых аритмий и внезапной сердечной смерти.

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The authors declare that there are no conflicts of interest present.