Possibility of the Heart Rate Variability Correction with a High Dose of Omega-3-polyunsaturated Fatty Acids in Patients with Acute Myocardial Infarction and Concomitant Type 2 Diabetes Mellitus

Aim: To evaluate the efficacy of a high dose (4g/day) of omega-3-PUFA on the heart rate variability (HRV) characteristics in patients with acute myocardial infarction (AMI) and Type 2 Diabetes Mellitus (T2DM) Material and Methods:The study included 93 patients with AMI and concomitant T2DM during the first 48 hours from the onset of the disease.Group 1 comprised 40 patients, who received the standard therapy for AMI.Group 2 consisted of 53 patients, who, in addition to the standard treatment, in the absence of contraindications received omega-3-PUFA (4g/day) from the first day of therapy.All patients underwent Holter ECG monitoring on the first and seventh days of hospitalization.Results: In the first 48 hours of AMI, a strong trend in reduction of SDNN value in the daytime and at night was marked in patients of both groups.There were no significant changes in HRV time-domain indicators during standard therapy in Group 1.In contrast, Group 2 was characterized by statistically significant increases in mRR and SDNN values in the daytime, as well as RMSSD and pNN50%.This trend was also observed at night.In Group 2, Mo and HRV TI (in daytime and at night) also changed significantly compared to baseline. Conclusion:In the patients with AMI and concomitant T2DM, there were significant changes in the main parameters of HRV that reflected the decrease in the activity of the parasympathetic nervous system and an increase in the activity of the sympathetic nervous system.Use of omega-3-PUFA in addition to standard therapy from the first hours of AMI allowed stabilization of the parasympathetic-sympathetic imbalance.