Abstract 294: Decreased Plasma Omega-3 to Omega-6 Polyunsaturated Fatty Acid Ratio Associated with Apical Ballooning Syndrome (Tako-Tsubo cardiomyopathy -TTC)

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Background: Eicosapentaenoic acid (EPA) of the omega-3 polyunsaturated fatty acids (ω-3 PUFA) family plays important roles in the prevention of cardiovascular disease, while, arachidonic acid (AA) of the ω-6 PUFA family promotes inflammatory and prothrombotic influences. Tako-Tsubo cardiomyopathy (TTC) is a heart syndrome associated with transient myocardial contractile dysfunction. Decreased endothelial function in response to acute mental stress has been reported in patients with a prior episode of TTC. However, the pathogenesis of TTC remains unclear and the relationship between TTC and EPA/AA ratio has not been elucidated.

Methods and Results: This study consisted of 10 consecutive patients with clinically diagnosed TTC. The aim of this study was to investigate the association between the plasma EPA/AA ratio and the early stage of clinically diagnosed TTC. To examine the plasma fatty acid level, blood samples were obtained from control, old myocardial infarction, and clinically diagnosed TTC patients. A clinically diagnosed TTC patients revealed a lower plasma EPA/AA ratio [Control patients, 0.58 (n=18) vs OMI patients, 0.38 (n=22) vs TTC patients, 0.12 (n=10), p=0.011]. High-sensitivity CRP levels and a low plasma EPA/AA ratio could independently predict the prevalence of TTC on multivariate logistic regression analysis [odds ratio 1.83 (95%CI 1.03-3.25), p=0.036 and odds ratio 2.05 (95%CI 1.12-3.92), p=0.02)].

Conclusion: In patients with TTC, a low plasma EPA/AA ratio was significantly associated with the early stage of clinically diagnosed TTC. The findings implicate lower EPA/AA ratio and the following endothelial dysfunction as a potential mechanism involved in the pathogenesis of this unique cardiomyopathy.

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