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This review evaluates the roles of fatty acids in cardiac health and disease and examines dietary interventions.

May 6, 2026Nutrients2 citationsOpen Access

Fatty Acids and Their Roles in Cardiac Physiology and Pathology: Mechanistic and Interventional Studies

RMRahul MallickUniversity of Eastern Finland PBPrasenjit BhowmikUppsala University PCPremanjali ChowdhuryUniversity of Eastern Finland

Key Points

This review evaluates the roles of fatty acids in cardiac health and disease and examines dietary interventions.
Reviewed existing literature on fatty acids and their impact on cardiac physiology and pathology.
Analyzed mechanisms by which fatty acids affect metabolism and inflammation.
Explored dietary and supplemental interventions to optimize cardiac lipid metabolism.
Fatty acids influence cardiac function and pathology, reducing inflammation and modulating heart failure.
High doses of n-3 fatty acids may increase atrial fibrillation risks.
Saturated and trans fatty acids are linked to higher rates of coronary artery disease.

Abstract

Fatty acids serve dual roles in cardiac physiology: as energy substrates and as precursors of bioactive lipid mediators (prostaglandins, leukotrienes, oxylipins) from n-3/n-6 PUFAs that regulate inflammation, thrombosis, and remodeling. Saturated, monounsaturated, and trans fatty acids modulate metabolism and membrane function, thereby shaping these pathways. Clinically, n-3 long-chain PUFAs (EPA and DHA) reduce cardiovascular mortality and aid postischemic remodeling; however, high doses increase the risk of atrial fibrillation. By contrast, trans and saturated fatty acids promote dyslipidemia, dysfunction, and higher rates of coronary artery disease and heart failure. Mechanistically, fatty acid uptake via FABPpm, CD36 (FAT), and FATPs, along with β-oxidation and PPAR signaling, regulates metabolism, while COX/LOX/CYP pathways generate eicosanoids and resolvins that influence inflammation and repair. This review synthesizes evidence on the roles of fatty acids and oxylipins in lipotoxicity, heart failure, ischemia–reperfusion, and arrhythmias, and evaluates dietary and supplemental interventions to optimize cardiac lipid metabolism, aligning with fatty acid signaling.

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