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EXPEDITED REVIEW

Dietary Linolenic Acid and Adjusted QT and JT Intervals in the National Heart, Lung, and Blood Institute Family Heart Study

Luc Djoussé, MD, DSc, MPH^_*,_*, Pentti M. Rautaharju, MD, PhD, Paul N. Hopkins, MD, MSPH, Eric A. Whitsel, MD, MPH, Donna K. Arnett, PhD, MSPH^||, John H. Eckfeldt, MD, PhD^¶, Michael A. Province, PhD^#, R. Curtis Ellison, MD^_* Investigators of the NHLBI Family Heart Study

^_* Section of Preventive Medicine & Epidemiology, Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
Department of Community Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Department of Cardiovascular Genetics, University of Utah, Salt Lake City, Utah
Department of Medicine and Epidemiology, University of North Carolina, Chapel Hill, North Carolina
^|| Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
^¶ Department of Laboratory Medicine and Pathology, Fairview-University Medical Center, Minneapolis, Minnesota
^# Division of Biostatistics, Washington University, St. Louis, Missouri

Manuscript received October 29, 2004; revised manuscript received December 16, 2004, accepted January 11, 2005.

^_* Reprint requests and correspondence: Dr. Luc Djoussé, Boston University School of Medicine, Room B-612, 715 Albany Street, Boston, Massachusetts 02118 (Email: ldjousse{at}bu.edu).

OBJECTIVES: The goal of this study was to examine whether higher consumption of total linolenic acid was associated with rate-adjusted QT and JT intervals (QTrr and JTrr, respectively).

BACKGROUND: Higher intake of fish omega-3 fatty acids and plant omega-3 such as alpha-linolenic acid is associated with lower risk of myocardial infarction. While long-chain omega-3 can inhibit ventricular arrhythmia, it is not known whether alpha-linolenic acid influences ventricular repolarization.

METHODS: We studied 3,642 subjects from the National Heart, Lung, and Blood Institute Family Heart study who were free of myocardial infarction, left ventricular hypertrophy, pacemaker, and with QRS <120 ms. We used the 95th percentile of the gender-specific distribution of QTrr and JTrr to define abnormally prolonged repolarization. Within each gender, we created age- and energy-adjusted tertiles of linolenic acid and used regression models for analyses.

RESULTS: Mean age was 50 years, and average intake of total linolenic acid was 0.74 g/day. There was an inverse association between consumption of linolenic acid and QTrr and JTrr (p for trend 0.001 and 0.0005, respectively). From the lowest (reference) to the highest gender-, age-, and energy-adjusted tertile of linolenic acid, multivariable adjusted odds ratios for prolonged QTrr were 1.0, 0.74 (95% confidence interval [CI] 0.57 to 0.96), and 0.59 (95% CI 0.44 to 0.77), respectively (p for trend 0.0003). Corresponding values for JTrr were 1.0, 0.73 (95% CI 0.52 to 1.03), and 0.59 (95% CI 0.40 to 0.87), respectively (p for trend 0.009). Exclusion of subjects taking drugs known to influence QT did not influence this association.

CONCLUSIONS: Higher intake of dietary linolenic acid might be associated with a reduced risk of abnormally prolonged repolarization in men and women.

Abbreviations and Acronyms   AA = arachidonic acid   CAD = coronary artery disease   CI = confidence interval   DHA = docosahexaenoic acid   ECG = electrocardiogram/electrocardiographic   EPA = eicosapentaenoic acid   JTrr = rate-adjusted JT interval as JT – 176·[(60/HR) – 1] + 14 for men (HR = heart rate)   NHLBI = National Heart, Lung, and Blood Institute   QTc = rate-adjusted QT interval as QT/RR1/2   QTrr = rate-adjusted QT interval as QT – 185·[(60/HR) – 1] + 6 for men (HR = heart rate)

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