Efficacy and Safety of Adding Omega-3 Fatty Acids in Statin-treated Patients with Residual Hypertriglyceridemia: ROMANTIC (Rosuvastatin-OMAcor iN residual hyperTrIglyCeridemia), a Randomized, Double-blind, and Placebo-controlled Trial.

PURPOSE: The purpose of this study was to examine the efficacy and safety of adding ω-3 fatty acids to rosuvastatin in patients with residual hypertriglyceridemia despite statin treatment. METHODS: This study was a multicenter, randomized, double-blind, placebo-controlled study. After a 4-week run-in period of rosuvastatin treatment, the patients who had residual hypertriglyceridemia were randomized to receive rosuvastatin 20 mg/d plus ω-3 fatty acids 4 g/d (ROSUMEGA group) or rosuvastatin 20 mg/d (rosuvastatin group) with a 1:1 ratio and were prescribed each medication for 8 weeks. FINDINGS: A total of 201 patients were analyzed (mean [SD] age, 58.1 [10.7] years; 62.7% male). After 8 weeks of treatment, the percentage change from baseline in triglycerides (TGs) and non-HDL-C was significantly greater in the ROSUMEGA group than in the rosuvastatin group (TGs: -26.3% vs -11.4%, P < 0.001; non-HDL-C: -10.7% vs -2.2%, P = 0.001). In the linear regression analysis, the lipid-lowering effect of ω-3 fatty acids was greater when baseline TG or non-HDL-C levels were high and body mass index was low. The incidence of adverse events was not significantly different between the 2 groups. IMPLICATIONS: In patients with residual hypertriglyceridemia despite statin treatment, a combination of ω-3 fatty acids and rosuvastatin produced a greater reduction of TGs and non-HDL-C than rosuvastatin alone. Further study is needed to determine whether the advantages of this lipid profile of ω-3 fatty acids actually leads to the prevention of cardiovascular event. ClinicalTrials.gov identifier: NCT03026933.

The response of the vena cava to abdominal breathing.

BACKGROUND: Recently, abdominal-breathing or diaphragmatic-breathing methods have increased in popularity. Little is known how abdominal breathing affects the circulatory system. This study was designed to determine the impact of the respiratory pattern on central venous flow using echocardiography. METHODS: The superior vena cava (SVC) and inferior vena cava (IVC) were observed in people who had practiced abdominal breathing for at least 2 years, while they were breathing in three different techniques: slow respiration, slow respiration with inspiratory pause, or normal respiration. In addition, the observation during normal respiration was compared with that of a control group. RESULTS: The abdominal-breathing group consisted of 20 people with mean duration of training of 9.6 years. The respiratory collapsibility index of IVC during slow respiration with inspiratory pause was 62±19% compared with 48±19% during normal respiration (p=0.012) in the abdominal-breathing group. The abdominal-breathing group had a higher IVC collapsibility index compared to the control group during normal respiration (48±19% versus 26±12%, p<0.001), assuming a similar respiratory rate of about 10/min. Neither the size nor the minute flow of SVC differed among breathing patterns or between groups. CONCLUSIONS: The IVC of people who practice abdominal breathing has a greater degree of collapse than those of normal people, suggesting that abdominal-breathing exercise can positively affect venous return via IVC. For those who practice abdominal breathing, the collapsibility of the IVC is the best during slow respiration with inspiratory pause. The SVC did not seem to be affected by abdominal-breathing training.