Figure 3. Diagram of proposed clinical effects of n-3 PUFA-derived peroxides and reactive aldehydes in heart.

Many of the cardiovascular effects of n-3 PUFAs have been linked to their anti-thrombotic, antioxidant/anti-inflammatory, anti-arrhythmic, and vasorelaxing activities. We propose that many of these effects are mediated by n-3 PUFA-derived peroxides and reactive aldehydes. Moreover, to this list of well-known clinical effects of n-3 PUFAs we add enhanced mitochondrial biogenesis (i.e. gene expression) and antioxidant capacity in the myocardium, which would be expected to augment fatty acid oxidation and protect mitochondria against insults such as Ca²⁺ overload. The latter effects would be expected to have particular importance in clinical scenarios such as pathological cardiac hypertrophy and heart failure, conditions known to result in, or be a result of, mitochondrial dysfunction.