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Jia J, Sun Z, Tao X, Tong Y, Feng H, Yang J, Lu X, Qu C, Liu Z, Wu J. Association between oxidative balance score and heart failure in the older adults: Results from the NHANES 2005-2018. Heart Lung 2024; 68:107-115. [PMID: 38943717 DOI: 10.1016/j.hrtlng.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Heart failure (HF) imposes a substantial burden on older adults, and healthy diets and lifestyles may bring with benefits. However, quantifiable studies on the dietary and lifestyle risk factors for HF are scant. The Oxidative Balance Score (OBS) reflects the oxidative stress status of dietary components and lifestyle factors, but its relationship with HF risk is unclear. OBJECTIVE We aims to explore the association between OBS and the prevalence of HF. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, the association between OBS and the HF prevalence was analyzed by weighted logistic regression and restricted cubic splines (RCS). Subgroup and sensitivity analyses assessed the stability of the results. RESULTS The prevalence of HF in the cohort of 6238 older adults was 5.55 %. Compared to the lowest quintile, the adjusted ORs for HF in the highest quintile of OBS and lifestyle OBS were 0.57 (95 % CI: 0.33,0.97) and 0.21 (95 %CI: 0.09,0.50), respectively. The association between OBS and HF prevalence remained stable across different models and subgroups. RCS revealed a potential inflection point. Sensitivity analysis validated the negative association between OBS and HF prevalence, and the correlation analysis between OBS and serum γ-glutamyltransferase (γ-GGT) confirmed the reliability of the study design. CONCLUSION The OBS is negatively associated with HF prevalence in older adults, and may help prevent HF in this population.
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Affiliation(s)
- Jian Jia
- Department of General Practice, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China
| | - Zhonghua Sun
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China
| | - Xinyu Tao
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China
| | - Yanli Tong
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China
| | - Han Feng
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China
| | - Jiahui Yang
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Hospital of Nanjing Medical University, Nanjing 211166, PR China
| | - Chen Qu
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China.
| | - Zhengxia Liu
- Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, PR China.
| | - Jun Wu
- Department of Geriatric Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
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de Man AME, Amrein K, Casaer MP, Dizdar OS, van Zanten ARH, Gundogan K, Lepp L, Rezzi S, Shenkin A, Berger MM. LLL 44-4 : Micronutrients in acute disease and critical illness. Clin Nutr ESPEN 2024; 61:437-446. [PMID: 38777466 DOI: 10.1016/j.clnesp.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024]
Abstract
Micronutrients (MN), i.e. trace elements and vitamins, are essential components of the diet in relatively small amounts in any form of nutrition, with special needs in critically ill patients. Critical illness is characterised by the presence of inflammation and oxidative stress. MNs are tightly involved in antioxidant and immune defences. In addition, some conditions, and treatments result in large losses of biological fluids containing MNs: therefore, acute renal injury requiring renal replacement therapy, acute intestinal failure, and major burns and trauma are at high risk of acute depletion of body stores, and of deficiency. MN requirements are increased above standard DRI. Blood level interpretation is complicated by inflammation: some biomarkers assist the status determination. Due to the acute challenges of critical illness, it of utmost importance to cover the needs to maintain the organism's endogenous immune and antioxidant defences, and capacity to repair tissues. Practical strategies are proposed.
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Affiliation(s)
- Angélique M E de Man
- Amsterdam UMC, Location Vrije Universiteit, Department of Intensive Care, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Oguzhan S Dizdar
- Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
| | - Arthur R H van Zanten
- Gelderse Vallei Hospital, Ede and Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey; North Estonia Regional Hospital, Tallinn, Estonia.
| | - Liis Lepp
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation, Epalinges, Switzerland.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland.
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Milutinovic S, Jancic P, Adam A, Radovanovic M, Nordstrom CW, Ward M, Petrovic M, Jevtic D, Delibasic M, Kotseva M, Nikolajevic M, Dumic I. Cardiomyopathy in Celiac Disease: A Systematic Review. J Clin Med 2024; 13:1045. [PMID: 38398359 PMCID: PMC10889265 DOI: 10.3390/jcm13041045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Cardiomyopathy in celiac disease or celiac cardiomyopathy (CCM) is a serious and potentially life-threatening disease that can occur in both adults and children. However, data supporting the causal relationship between celiac disease (CD) and cardiomyopathy (CMP) are still inconsistent. The aim of this study was to review and synthesize data from the literature on this topic and potentially reveal a more evidence-based causal relationship. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to search Medline, Embase, and Scopus databases from database inception until September 2023. A total of 1187 original articles were identified. (3) Results: We identified 28 CCM patients (19 adult and 9 pediatric) with a mean age of 27.4 ± 18.01 years. Adult patients with CCM were predominantly male (84.2%) while pediatric patients were predominantly female (75%). The most common comorbidities associated with CCM were anemia (75%) and pulmonary hemosiderosis (20%). In 35% of patients, CCM occurred before the diagnosis of CD, while in 48% of patients, CCM and CD were diagnosed at the same time. Diagnosis of CD preceded diagnosis of CCM in only 18% of patients. Diagnosis of CCM is often delayed with an average, from the onset of symptoms to diagnosis, of 16 months. All patients were treated with a gluten-free diet in addition to guideline-directed medical therapy. At 11-month follow-up, cardiovascular improvement was seen in 60.7% of patients. Pediatric mortality was 33.3%, while adult mortality was 5.3%. (4) Conclusions: Clinicians should be aware of the possible association between CD and CMP, and we recommend CD work-up in all patients with CMP who have concomitant anemia. While we identified only 28 cases in the literature, many cases might go unreported due to a lack of awareness regarding CCM. A high degree of clinical suspicion and a prompt diagnosis of CCM are essential to minimizing the risks of morbidity and mortality, as the combination of a gluten-free diet and guideline-directed medical therapy can improve clinical outcomes.
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Affiliation(s)
- Stefan Milutinovic
- Internal Medicine Residency Program at Lee Health, Florida State University College of Medicine, Tallahassee, FL 32301, USA; (S.M.); (M.D.)
| | - Predrag Jancic
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (P.J.); (M.N.)
| | - Adam Adam
- Cardiology Fellowship Program, Cook County, Chicago, IL 60612, USA;
| | - Milan Radovanovic
- Section of Hospital Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, USA; (M.R.); (M.W.)
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA;
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Charles W. Nordstrom
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA;
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Marshall Ward
- Section of Hospital Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, USA; (M.R.); (M.W.)
| | - Marija Petrovic
- Cardiology Fellowship Program, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | | | - Maja Delibasic
- Internal Medicine Residency Program at Lee Health, Florida State University College of Medicine, Tallahassee, FL 32301, USA; (S.M.); (M.D.)
| | | | - Milan Nikolajevic
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (P.J.); (M.N.)
| | - Igor Dumic
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA;
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
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4
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Hahn M, Wood A, Hasse JM. Nutrition support management of organ transplant recipients in the acute posttransplant phase. Nutr Clin Pract 2024; 39:45-58. [PMID: 38081296 DOI: 10.1002/ncp.11104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 01/13/2024] Open
Abstract
Patients who undergo solid organ transplant can have an extensive and challenging postoperative course. The chronicity of the disease state prior to transplant in combination with transplant-specific complications and immunosuppressant medications can lead to distinct challenges that are not observed in other critically ill patients. Although the manifestation of posttransplant complications may be specific to the organ being transplanted, there are common transplant challenges that affect nutrition therapy in these patients. Effects of malnutrition, metabolic aberrations, and posttransplant organ dysfunction should be considered when developing a nutrition care plan for patients in the immediate posttransplant phase. This article addresses the various complications that can arise in the immediate posttransplant phase among patients undergoing solid organ transplant and the appropriate nutrition interventions or considerations for this specialized patient population.
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Affiliation(s)
- Michaelann Hahn
- Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA
| | - Abby Wood
- Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA
| | - Jeanette M Hasse
- Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA
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Wood JC. Cardiac complications in thalassemia throughout the lifespan: Victories and challenges. Ann N Y Acad Sci 2023; 1530:64-73. [PMID: 37902424 PMCID: PMC10841366 DOI: 10.1111/nyas.15078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Thalassemias are among the most common hereditary diseases in the world because heterozygosity offers protection against malarial infection. Affected individuals have variable expression of alpha or beta chains that lead to their unbalanced utilization during hemoglobin formation, oxidative stress, and apoptosis of red cell precursors prior to maturation. Some individuals produce sufficient hemoglobin to survive but suffer the vascular stress imposed by chronic anemia and ineffective erythropoiesis. In other patients, mature red cell formation is insufficient, and chronic transfusions are required-suppressing anemia and ineffective erythropoiesis but at the expense of iron overload. The cardiovascular consequences of thalassemia have changed dramatically over the previous five decades because of evolving treatment practices. This review summarizes this evolution, focusing on complications and management pertinent to modern patient cohorts.
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Affiliation(s)
- John C Wood
- Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, California, USA
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6
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Nguyen HTT, Ha TTT, Tran HB, Nguyen DV, Pham HM, Tran PM, Pham TM, Allison TG, Reid CM, Kirkpatrick JN. Relationship between BMI and prognosis of chronic heart failure outpatients in Vietnam: a single-center study. Front Nutr 2023; 10:1251601. [PMID: 38099185 PMCID: PMC10720040 DOI: 10.3389/fnut.2023.1251601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Background Insufficient data exists regarding the relationship between body mass index (BMI) and the prognosis of chronic heart failure (CHF) specifically within low- and middle-income Asian countries. The objective of this study was to evaluate the impact of BMI on adverse outcomes of ambulatory patients with CHF in Vietnam. Methods Between 2018 and 2020, we prospectively enrolled consecutive outpatients with clinically stable CHF in an observational cohort, single-center study. The participants were stratified according to Asian-specific BMI thresholds. The relationships between BMI and adverse outcomes (all-cause death and all-cause hospitalization) were analyzed by Kaplan-Meier survival curves and Cox proportional-hazards model. Results Among 320 participants (age 63.5 ± 13.3 years, 57.9% male), the median BMI was 21.4 kg/m2 (IQR 19.5-23.6), and 10.9% were underweight (BMI <18.50 kg/m2). Over a median follow-up time of 32 months, the cumulative incidence of all-cause mortality and hospitalization were 5.6% and 19.1%, respectively. After multivariable adjustment, underweight patients had a significantly higher risk of all-cause mortality than patients with normal BMI (adjusted hazard ratios = 3.03 [95% CI: 1.07-8.55]). Lower BMI remained significantly associated with a worse prognosis when analyzed as a continuous variable (adjusted hazard ratios = 1.27 [95% CI: 1.03-1.55] per 1 kg/m2 decrease for all-cause mortality). However, BMI was not found to be significantly associated with the risk of all-cause hospitalization (p > 0.05). Conclusion In ambulatory patients with CHF in Vietnam, lower BMI, especially underweight status (BMI < 18.5 kg/m2), was associated with a higher risk of all-cause mortality. These findings suggest that BMI should be considered for use in risk classification, and underweight patients should be managed by a team consisting of cardiologists, nutritionists, and geriatricians.
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Affiliation(s)
- Hoai Thi Thu Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Thuong Thi Thu Ha
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hieu Ba Tran
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Dung Viet Nguyen
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hung Manh Pham
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Phuong Minh Tran
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Minh Pham
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Thomas G. Allison
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Christopher M. Reid
- School of Population Health, Curtin University, Perth, WA, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - James N. Kirkpatrick
- Cardiovascular Division, Department of Medicine, University of Washington Medical Center, Seattle, WA, United States
- Department of Bioethics and Humanities, University of Washington Medical Center, Seattle, WA, United States
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7
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Soto ME, Pérez-Torres I, Rubio-Ruiz ME, Manzano-Pech L, Guarner-Lans V. Interconnection between Cardiac Cachexia and Heart Failure—Protective Role of Cardiac Obesity. Cells 2022; 11:cells11061039. [PMID: 35326490 PMCID: PMC8946995 DOI: 10.3390/cells11061039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023] Open
Abstract
Cachexia may be caused by congestive heart failure, and it is then called cardiac cachexia, which leads to increased morbidity and mortality. Cardiac cachexia also worsens skeletal muscle degradation. Cardiac cachexia is the loss of edema-free muscle mass with or without affecting fat tissue. It is mainly caused by a loss of balance between protein synthesis and degradation, or it may result from intestinal malabsorption. The loss of balance in protein synthesis and degradation may be the consequence of altered endocrine mediators such as insulin, insulin-like growth factor 1, leptin, ghrelin, melanocortin, growth hormone and neuropeptide Y. In contrast to many other health problems, fat accumulation in the heart is protective in this condition. Fat in the heart can be divided into epicardial, myocardial and cardiac steatosis. In this review, we describe and discuss these topics, pointing out the interconnection between heart failure and cardiac cachexia and the protective role of cardiac obesity. We also set the basis for possible screening methods that may allow for a timely diagnosis of cardiac cachexia, since there is still no cure for this condition. Several therapeutic procedures are discussed including exercise, nutritional proposals, myostatin antibodies, ghrelin, anabolic steroids, anti-inflammatory substances, beta-adrenergic agonists, medroxyprogesterone acetate, megestrol acetate, cannabinoids, statins, thalidomide, proteasome inhibitors and pentoxifylline. However, to this date, there is no cure for cachexia.
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Affiliation(s)
- María Elena Soto
- Department of Immunology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico;
| | - Israel Pérez-Torres
- Department of Cardiovascular Biomedicine, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (I.P.-T.); (L.M.-P.)
| | - María Esther Rubio-Ruiz
- Department of Physiology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico;
| | - Linaloe Manzano-Pech
- Department of Cardiovascular Biomedicine, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (I.P.-T.); (L.M.-P.)
| | - Verónica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico;
- Correspondence:
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8
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Saha S, Singh PK, Roy P, Kakar SS. Cardiac Cachexia: Unaddressed Aspect in Cancer Patients. Cells 2022; 11:cells11060990. [PMID: 35326441 PMCID: PMC8947289 DOI: 10.3390/cells11060990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
Tumor-derived cachectic factors such as proinflammatory cytokines and neuromodulators not only affect skeletal muscle but also affect other organs, including the heart, in the form of cardiac muscle atrophy, fibrosis, and eventual cardiac dysfunction, resulting in poor quality of life and reduced survival. This article reviews the holistic approaches of existing diagnostic, pathophysiological, and multimodal therapeutic interventions targeting the molecular mechanisms that are responsible for cancer-induced cardiac cachexia. The major drivers of cardiac muscle wasting in cancer patients are autophagy activation by the cytokine-NFkB, TGF β-SMAD3, and angiotensin II-SOCE-STIM-Ca2+ pathways. A lack of diagnostic markers and standard treatment protocols hinder the early diagnosis of cardiac dysfunction and the initiation of preventive measures. However, some novel therapeutic strategies, including the use of Withaferin A, have shown promising results in experimental models, but Withaferin A’s effectiveness in human remains to be verified. The combined efforts of cardiologists and oncologists would help to identify cost effective and feasible solutions to restore cardiac function and to increase the survival potential of cancer patients.
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Affiliation(s)
- Sarama Saha
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh 249203, India; (S.S.); (P.K.S.)
| | - Praveen Kumar Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh 249203, India; (S.S.); (P.K.S.)
| | - Partha Roy
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee 247667, India;
| | - Sham S. Kakar
- Department of Physiology and Brown Cancer Center, University of Louisville, Louisville, KY 40292, USA
- Correspondence: ; Tel.: +1-(502)-852-0812
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9
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Gaburjakova J, Gaburjakova M. The Cardiac Ryanodine Receptor Provides a Suitable Pathway for the Rapid Transport of Zinc (Zn2+). Cells 2022; 11:cells11050868. [PMID: 35269490 PMCID: PMC8909583 DOI: 10.3390/cells11050868] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022] Open
Abstract
The sarcoplasmic reticulum (SR) in cardiac muscle is suggested to act as a dynamic storage for Zn2+ release and reuptake, albeit it is primarily implicated in the Ca2+ signaling required for the cardiac cycle. A large Ca2+ release from the SR is mediated by the cardiac ryanodine receptor (RYR2), and while this has a prominent conductance for Ca2+ in vivo, it also conducts other divalent cations in vitro. Since Zn2+ and permeant Mg2+ have similar physical properties, we tested if the RYR2 channel also conducts Zn2+. Using the method of planar lipid membranes, we evidenced that the RYR2 channel is permeable to Zn2+ with a considerable conductance of 81.1 ± 2.4 pS, which was significantly lower than the values for Ca2+ (127.5 ± 1.8 pS) and Mg2+ (95.3 ± 1.4 pS), obtained under the same asymmetric conditions. Despite similar physical properties, the intrinsic Zn2+ permeability (PCa/PZn = 2.65 ± 0.19) was found to be ~2.3-fold lower than that of Mg2+ (PCa/PMg = 1.146 ± 0.071). Further, we assessed whether the channel itself could be a direct target of the Zn2+ current, having the Zn2+ finger extended into the cytosolic vestibular portion of the permeation pathway. We attempted to displace Zn2+ from the RYR2 Zn2+ finger to induce its structural defects, which are associated with RYR2 dysfunction. Zn2+ chelators were added to the channel cytosolic side or strongly competing cadmium cations (Cd2+) were allowed to permeate the RYR2 channel. Only the Cd2+ current was able to cause the decay of channel activity, presumably as a result of Zn2+ to Cd2+ replacement. Our findings suggest that the RYR2 channel can provide a suitable pathway for rapid Zn2+ escape from the cardiac SR; thus, the channel may play a role in local and/or global Zn2+ signaling in cardiomyocytes.
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10
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Claxton L, Simmonds M, Beresford L, Cubbon R, Dayer M, Gottlieb SS, Hartshorne-Evans N, Kilroy B, Llewellyn A, Rothery C, Sharif S, Tierney JF, Witte KK, Wright K, Stewart LA. Coenzyme Q10 to manage chronic heart failure with a reduced ejection fraction: a systematic review and economic evaluation. Health Technol Assess 2022; 26:1-128. [PMID: 35076012 DOI: 10.3310/kvou6959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chronic heart failure is a debilitating condition that accounts for an annual NHS spend of £2.3B. Low levels of endogenous coenzyme Q10 may exacerbate chronic heart failure. Coenzyme Q10 supplements might improve symptoms and slow progression. As statins are thought to block the production of coenzyme Q10, supplementation might be particularly beneficial for patients taking statins. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of coenzyme Q10 in managing chronic heart failure with a reduced ejection fraction. METHODS A systematic review that included randomised trials comparing coenzyme Q10 plus standard care with standard care alone in chronic heart failure. Trials restricted to chronic heart failure with a preserved ejection fraction were excluded. Databases including MEDLINE, EMBASE and CENTRAL were searched up to March 2020. Risk of bias was assessed using the Cochrane Risk of Bias tool (version 5.2). A planned individual participant data meta-analysis was not possible and meta-analyses were mostly based on aggregate data from publications. Potential effect modification was examined using meta-regression. A Markov model used treatment effects from the meta-analysis and baseline mortality and hospitalisation from an observational UK cohort. Costs were evaluated from an NHS and Personal Social Services perspective and expressed in Great British pounds at a 2019/20 price base. Outcomes were expressed in quality-adjusted life-years. Both costs and outcomes were discounted at a 3.5% annual rate. RESULTS A total of 26 trials, comprising 2250 participants, were included in the systematic review. Many trials were reported poorly and were rated as having a high or unclear risk of bias in at least one domain. Meta-analysis suggested a possible benefit of coenzyme Q10 on all-cause mortality (seven trials, 1371 participants; relative risk 0.68, 95% confidence interval 0.45 to 1.03). The results for short-term functional outcomes were more modest or unclear. There was no indication of increased adverse events with coenzyme Q10. Meta-regression found no evidence of treatment interaction with statins. The base-case cost-effectiveness analysis produced incremental costs of £4878, incremental quality-adjusted life-years of 1.34 and an incremental cost-effectiveness ratio of £3650. Probabilistic sensitivity analyses showed that at thresholds of £20,000 and £30,000 per quality-adjusted life-year coenzyme Q10 had a high probability (95.2% and 95.8%, respectively) of being more cost-effective than standard care alone. Scenario analyses in which the population and other model assumptions were varied all found coenzyme Q10 to be cost-effective. The expected value of perfect information suggested that a new trial could be valuable. LIMITATIONS For most outcomes, data were available from few trials and different trials contributed to different outcomes. There were concerns about risk of bias and whether or not the results from included trials were applicable to a typical UK population. A lack of individual participant data meant that planned detailed analyses of effect modifiers were not possible. CONCLUSIONS Available evidence suggested that, if prescribed, coenzyme Q10 has the potential to be clinically effective and cost-effective for heart failure with a reduced ejection fraction. However, given important concerns about risk of bias, plausibility of effect sizes and applicability of the evidence base, establishing whether or not coenzyme Q10 is genuinely effective in a typical UK population is important, particularly as coenzyme Q10 has not been subject to the scrutiny of drug-licensing processes. Stronger evidence is needed before considering its prescription in the NHS. FUTURE WORK A new independent, well-designed clinical trial of coenzyme Q10 in a typical UK heart failure with a reduced ejection fraction population may be warranted. STUDY REGISTRATION This study is registered as PROSPERO CRD42018106189. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Lindsay Claxton
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Simmonds
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lucy Beresford
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Richard Cubbon
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Dayer
- Department of Cardiology, Somerset NHS Foundation Trust, University of Exeter, Exeter, UK
| | | | | | | | - Alexis Llewellyn
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Claire Rothery
- Centre for Health Economics, University of York, York, UK
| | - Sahar Sharif
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Jayne F Tierney
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Klaus K Witte
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
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11
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Walters GWM, Redman E, Gulsin GS, Henson J, Argyridou S, Yates T, Davies MJ, Parke K, McCann GP, Brady EM. Interrelationship between micronutrients and cardiovascular structure and function in type 2 diabetes. J Nutr Sci 2021; 10:e88. [PMID: 34733500 PMCID: PMC8532075 DOI: 10.1017/jns.2021.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022] Open
Abstract
Micronutrients are important for normal cardiovascular function. They may play a role in the increased risk of cardiovascular disease observed in people with type 2 diabetes (T2D) and T2D-related heart failure. The aims of this study were to (1) examine micronutrient status in people with T2D v. healthy controls; (2) assess any changes following a nutritionally complete meal replacement plan (MRP) compared with routine care; (3) determine if any changes were associated with changes in cardiovascular structure/function. This was a secondary analysis of data from a prospective, randomised, open-label, blinded end-point trial of people with T2D, with a nested case-control [NCT02590822]. Anthropometrics, cardiac resonance imaging and fasting blood samples (to quantify vitamins B1, B6, B12, D and C; and iron and ferritin) were collected at baseline and 12 weeks following the MRP or routine care. Comparative data in healthy controls were collected at baseline. A total of eighty-three people with T2D and thirty-six healthy controls were compared at baseline; all had micronutrient status within reference ranges. Vitamin B1 was higher (148⋅9 v. 131⋅7; P 0⋅01) and B6 lower (37⋅3 v. 52⋅9; P 0⋅01) in T2D v. controls. All thirty participants randomised to routine care and twenty-four to the MRP completed the study. There was an increase in vitamins B1, B6, D and C following the MRP, which were not associated with changes in cardiovascular structure/function. In conclusion, changes in micronutrient status following the MRP were not independently associated with improvements in cardiovascular structure/function in people with T2D.
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Key Words
- BMI, body mass index
- CMR
- CMR, cardiac magnetic resonance imaging
- CVD, cardiovascular disease
- Cardiovascular function
- EF, ejection fraction
- HF, heart failure
- LV, left ventricular
- Low calorie
- Low-energy meal replacement plan
- MRP, meal replacement plan
- Micronutrients
- PLP, pyridoxal 5-phosphate
- RCT, randomised control trial
- T2D, type 2 diabetes
- Type 2 diabetes
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Affiliation(s)
- Grace W. M. Walters
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Emma Redman
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Gaurav S. Gulsin
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Joseph Henson
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Thomas Yates
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J. Davies
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kelly Parke
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Gerry P. McCann
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Emer M. Brady
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
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12
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Ryuge A, Kim H, Suzuki Y, Okazaki M, Kojima H, Saito S, Kato N, Ishimoto T, Kosugi T, Maruyama S, Mizuno M. Refractory Hypotension Caused by Selenium Deficiency in a Patient on Peritoneal Dialysis. Intern Med 2021; 60:2461-2464. [PMID: 33583900 PMCID: PMC8381165 DOI: 10.2169/internalmedicine.6632-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Selenium is essential for human health; its deficiency leads to cardiac dysfunction. We herein report a 79-year-old man on peritoneal dialysis who presented with refractory hypotension caused by selenium deficiency. He was admitted to our hospital with bacterial pneumonia and hypotension and abnormal electrocardiogram (ECG) findings. Despite improvement of pneumonia, his hypotension continued, and intravenous noradrenalin could not be discontinued. His serum selenium level was extremely low, and he was started on intravenous selenium. His hypotension and ECG findings gradually improved, and noradrenalin was discontinued. Physicians should consider selenium deficiency when patients on peritoneal dialysis show refractory hypotension.
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Affiliation(s)
- Akihiro Ryuge
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Hangsoo Kim
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Yasuhiro Suzuki
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Masaki Okazaki
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Hiroshi Kojima
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Shoji Saito
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Noritoshi Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Takuji Ishimoto
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Tomoki Kosugi
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
| | - Masashi Mizuno
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
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13
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Das A, Cumming RG, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Ribeiro RVR, Simpson SJ, Hirani V. Dietary and supplemental antioxidant intake and risk of major adverse cardiovascular events in older men: The concord health and ageing in men project. Nutr Metab Cardiovasc Dis 2021; 31:1102-1112. [PMID: 33549432 DOI: 10.1016/j.numecd.2020.11.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The role of antioxidant intake in cardiovascular disease remains inconclusive. This study evaluates the association between antioxidant intake and the risk of major adverse cardiovascular events (MACE) among older Australian men. METHODS AND RESULTS 794 men aged ≥75 years participated in the 3rd wave of the Concord Health and Ageing in Men Project. Dietary adequacy of antioxidant intake was assessed by comparing participants' intake of vitamins A, E, C and zinc to the Nutrient Reference Values (NRV) for Australia. Attainment of NRVs of antioxidants was categorised into a dichotomised variable 'inadequate' (meeting≤2 of 4 antioxidants) or 'adequate' (meeting≥3 of 4 antioxidants). The usage of antioxidant supplements was assessed. The outcome measure was MACE. The composite MACE endpoint was defined as having one of the following: death, myocardial infarction, ischemic stroke, congestive cardiac failure (CCF), and revascularization during the period of observation. There was no significant association between dietary (HR: 1.03, 95% CI: 0.71, 1.48) or supplemental antioxidant intake (HR: 1.10, 95% CI: 0.75, 1.63) and overall MACE. However, a significant association was observed between inadequate antioxidant intake and CCF (HR: 1.32; 95% CI: 1.16, 1.50). The lowest quartile of zinc intake (<11.00 mg/d) was significantly associated with CCF (HR 2.36; 95% CI: 1.04, 5.34). None of the other antioxidants were significantly associated with CCF or other MACE components. CONCLUSION Inadequate dietary antioxidant intake, particularly zinc, is associated with increased risk of CCF in older Australian men but not associated with overall MACE.
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Affiliation(s)
- Arpita Das
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Australia.
| | - Robert G Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Australia; School of Public Health, University of Sydney, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
| | - Rosilene V R Ribeiro
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Stephen J Simpson
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Vasant Hirani
- School of Life and Environmental Science Charles Perkins Centre, University of Sydney, Sydney, Australia; ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia; Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia
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14
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Obata Y, Kakutani N, Kinugawa S, Fukushima A, Yokota T, Takada S, Ono T, Sota T, Kinugasa Y, Takahashi M, Matsuo H, Matsukawa R, Yoshida I, Yokota I, Yamamoto K, Tsuchihashi-Makaya M. Impact of Inadequate Calorie Intake on Mortality and Hospitalization in Stable Patients with Chronic Heart Failure. Nutrients 2021; 13:nu13030874. [PMID: 33800134 PMCID: PMC7998469 DOI: 10.3390/nu13030874] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022] Open
Abstract
Malnutrition is highly prevalent in patients with heart failure (HF), but the precise impact of dietary energy deficiency on HF patients' clinical outcomes is not known. We investigated the associations between inadequate calorie intake and adverse clinical events in 145 stable outpatients with chronic HF who had a history of hospitalization due to worsening HF. To assess the patients' dietary pattern, we used a brief self-administered diet-history questionnaire (BDHQ). Inadequate calorie intake was defined as <60% of the estimated energy requirement. In the total chronic HF cohort, the median calorie intake was 1628 kcal/day. Forty-four patients (30%) were identified as having an inadequate calorie intake. A Kaplan-Meier analysis revealed that the patients with inadequate calorie intake had significantly worse clinical outcomes including all-cause death and HF-related hospitalization during the 1-year follow-up period versus those with adequate calorie intake (20% vs. 5%, p < 0.01). A multivariate logistic regression analysis showed that inadequate calorie intake was an independent predictor of adverse clinical events after adjustment for various factors that may influence patients' calorie intake. Among patients with chronic HF, inadequate calorie intake was associated with an increased risk of all-cause mortality and rehospitalization due to worsening HF. However, our results are preliminary and larger studies with direct measurements of dietary calorie intake and total energy expenditure are needed to clarify the intrinsic nature of this relationship.
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Affiliation(s)
- Yoshikuni Obata
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
| | - Naoya Kakutani
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyusyu University, Fukuoka 812-8582, Japan
- Correspondence: ; Tel.: +81-92-642-5360
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo 060-8648, Japan
| | - Shingo Takada
- Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (Y.O.); (N.K.); (A.F.); (T.Y.); (S.T.)
| | - Taisuke Ono
- Department of Cardiology, Kitami Red Cross Hospital, Kitami 090-8666, Japan;
| | - Takeshi Sota
- Division of Rehabilitation, Tottori University Hospital, Tottori 683-8504, Japan;
| | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (Y.K.); (K.Y.)
| | - Masashige Takahashi
- Department of Cardiology, Kushiro City General Hospital, Kushiro 085-0822, Japan;
| | - Hisashi Matsuo
- Department of Cardiology, Keiwakai Ebetsu Hospital, Ebetsu 069-0817, Japan;
| | - Ryuichi Matsukawa
- Division of Cardiology, Cardiovascular and Aortic Center, Saiseikai Fukuoka General Hospital, Fukuoka 810-0001, Japan;
| | - Ichiro Yoshida
- Department of Cardiology, Obihiro Kyokai Hospital, Obihiro 080-0805, Japan;
| | - Isao Yokota
- Department of Biostatistics, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan;
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (Y.K.); (K.Y.)
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15
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Abstract
Frailty has been defined as a state of increased vulnerability due to a decline in the reserve and function of multiple physiological systems. Initially conceived as a geriatric syndrome indicative of physiological aging, it is now apparent that frailty can also be observed as a manifestation of chronic disease states including heart failure. Estimates of the prevalence of frailty in heart failure vary according to the age of the study population and the frailty instrument used, however multiple studies have identified frailty to be prevalent in patients with advanced heart failure including those who are referred for heart transplantation. Frailty is emerging as an independent predictor of mortality both before and after bridge-to-transplant ventricular assist device (BTT VAD) implantation and heart transplantation. Frailty is also predictive of prolonged hospitalization following these procedures. Heart failure-associated frailty is a dynamic state. While reversibility of frailty can be anticipated in younger heart failure patients, predicting the reversibility of frailty is more challenging in older patients who often have multiple comorbidities that may contribute to the frailty syndrome. Prehabilitation is a promising approach to both preventing and reversing frailty however more research is urgently needed to establish its effectiveness in mitigating the adverse impacts of frailty on post-VAD and posttransplant morbidity and mortality.
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16
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Mollace V, Rosano GMC, Anker SD, Coats AJS, Seferovic P, Mollace R, Tavernese A, Gliozzi M, Musolino V, Carresi C, Maiuolo J, Macrì R, Bosco F, Chiocchi M, Romeo F, Metra M, Volterrani M. Pathophysiological Basis for Nutraceutical Supplementation in Heart Failure: A Comprehensive Review. Nutrients 2021; 13:257. [PMID: 33477388 PMCID: PMC7829856 DOI: 10.3390/nu13010257] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/25/2020] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
There is evidence demonstrating that heart failure (HF) occurs in 1-2% of the global population and is often accompanied by comorbidities which contribute to increasing the prevalence of the disease, the rate of hospitalization and the mortality. Although recent advances in both pharmacological and non-pharmacological approaches have led to a significant improvement in clinical outcomes in patients affected by HF, residual unmet needs remain, mostly related to the occurrence of poorly defined strategies in the early stages of myocardial dysfunction. Nutritional support in patients developing HF and nutraceutical supplementation have recently been shown to possibly contribute to protection of the failing myocardium, although their place in the treatment of HF requires further assessment, in order to find better therapeutic solutions. In this context, the Optimal Nutraceutical Supplementation in Heart Failure (ONUS-HF) working group aimed to assess the optimal nutraceutical approach to HF in the early phases of the disease, in order to counteract selected pathways that are imbalanced in the failing myocardium. In particular, we reviewed several of the most relevant pathophysiological and molecular changes occurring during the early stages of myocardial dysfunction. These include mitochondrial and sarcoplasmic reticulum stress, insufficient nitric oxide (NO) release, impaired cardiac stem cell mobilization and an imbalanced regulation of metalloproteinases. Moreover, we reviewed the potential of the nutraceutical supplementation of several natural products, such as coenzyme Q10 (CoQ10), a grape seed extract, Olea Europea L.-related antioxidants, a sodium-glucose cotransporter (SGLT2) inhibitor-rich apple extract and a bergamot polyphenolic fraction, in addition to their support in cardiomyocyte protection, in HF. Such an approach should contribute to optimising the use of nutraceuticals in HF, and the effect needs to be confirmed by means of more targeted clinical trials exploring the efficacy and safety of these compounds.
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Affiliation(s)
- Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Giuseppe M. C. Rosano
- Cardiology Clinical Academic Group, St George’s Hospitals NHS Trust University of London, London SW17 0QT, UK;
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy; (A.J.S.C.); (M.V.)
| | - Stefan D. Anker
- Department of Cardiology, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Andrew J. S. Coats
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy; (A.J.S.C.); (M.V.)
| | - Petar Seferovic
- Faculty of Medicine, Belgrade University, 11000 Belgrade, Serbia;
| | - Rocco Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
- Department of Experimental and Applied Medicine, Institute of Cardiology, University of Brescia, 25121 Brescia, Italy;
| | - Annamaria Tavernese
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
- Department of Experimental and Applied Medicine, Institute of Cardiology, University of Brescia, 25121 Brescia, Italy;
| | - Micaela Gliozzi
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Vincenzo Musolino
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Cristina Carresi
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Jessica Maiuolo
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Francesca Bosco
- Department of Health Sciences, Institute of Research for Food Safety & Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (C.C.); (J.M.); (R.M.); (F.B.)
| | - Marcello Chiocchi
- Department of Diagnostic Imaging and Interventional Radiology, Policlinico Tor Vergata, 00199 Rome, Italy;
| | - Francesco Romeo
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00199 Rome, Italy;
| | - Marco Metra
- Department of Experimental and Applied Medicine, Institute of Cardiology, University of Brescia, 25121 Brescia, Italy;
| | - Maurizio Volterrani
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy; (A.J.S.C.); (M.V.)
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17
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Khan N, Hashmi S, Siddiqui AJ, Farooq S, Sami SA, Basir N, Bokhari SS, Sharif H, Junejo S, El-Seedi HR, Musharraf SG. Understanding of metals dysregulation in patients with systolic and diastolic dysfunction in ischemic heart disease. Sci Rep 2020; 10:13948. [PMID: 32811884 PMCID: PMC7434915 DOI: 10.1038/s41598-020-70733-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/15/2020] [Indexed: 11/09/2022] Open
Abstract
Ischemic heart disease (IHD) is the leading cause of death and chronic disability in the world. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/eʹ), were correlated with differential regulation of various metals in patients sera samples (n = 62) using inductive coupled plasma-mass spectrometry (ICP-MS). Chromium, nickel and selenium were found significant (p < 0.05) in patients having EF < 45% compared with EF > 45%. In patients with systolic dysfunction (EF < 45%), the level of selenium was decreased while the level of chromium and nickel was increased compared to patients with EF > 45%. Selenium level was also decreased significantly (p < 0.05) in grade 1A and 2 patients that are considered as higher grades of diastole dysfunction in comparison to grade 0–1. Overall, selenium deficiency was identified in both systolic and diastolic dysfunctions of IHD patients corresponding to the progression of disease that could be related to many metabolic and translational pathways specifically which involve selenoproteins.
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Affiliation(s)
- Noman Khan
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Satwat Hashmi
- Department of Biological and Biomedical Sciences, Agha Khan University, Karachi, 74800, Pakistan
| | - Amna Jabbar Siddiqui
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Sabiha Farooq
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Shahid Ahmed Sami
- Department of Surgery, Aga Khan University, Karachi, 74800, Pakistan
| | - Nageeb Basir
- Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Hasanat Sharif
- Department of Surgery, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Hesham R El-Seedi
- Pharmacognosoy Group, Department of Medicinal Chemistry, Biomedical Centre, Uppsala University, Box 574, 75 123, Uppsala, Sweden. .,International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, 212013, China.
| | - Syed Ghulam Musharraf
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan. .,Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
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18
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Grant D, Tomlinson D, Tsintzas K, Kolic P, Onambele-Pearson G. Displacing Sedentary Behaviour with Light Intensity Physical Activity Spontaneously Alters Habitual Macronutrient Intake and Enhances Dietary Quality in Older Females. Nutrients 2020; 12:E2431. [PMID: 32823599 PMCID: PMC7469014 DOI: 10.3390/nu12082431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 01/06/2023] Open
Abstract
Displacing Sedentary Behaviour (SB) with light intensity physical activity (LIPA) is increasingly viewed as a viable means of health enhancement. It is, however, unclear whether any behavioural compensations accompany such an intervention. Therefore, the aim of this study was to identify any dietary changes that accompany SB displacement. We hypothesised that SB displacement would improve dietary quality. Thirty-five elderly females (73 ± 5 years) were randomly allocated to one of three groups: (1) sedentary behaviour fragmentation (SBF) (n = 14), (2) continuous LIPA (n = 14), or (3) control (n = 7). Habitual diet (four-day food diary) and physical behaviour (accelerometery) were assessed at weeks 0 and 8. Out of 45 nutrients examined, only glucose exhibited a group × time interaction (p = 0.03), mediated by an exclusive reduction following SBF (-31%). SBF was also the sole experimental group to increase nutrients promoting bone health (SBF: 17%, LIPA: -34%. control: 21%), whereas both experimental groups consumed more nutrients promoting anabolism (SBF: 13%, LIPA: 4%, control: -34%) (z-scores). New ambulators (n = 8) also consumed more nutrients promoting bone health (16%)/anabolism (2%) (z-scores), including significantly increased Zinc intake (p = 0.05, 29%). Displacing SB with LIPA improves dietary quality in older females. Furthermore, SB fragmentation appears advantageous for various dietary outcomes.
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Affiliation(s)
- Dale Grant
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK; (D.T.); (P.K.); (G.O.-P.)
| | - David Tomlinson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK; (D.T.); (P.K.); (G.O.-P.)
| | - Kostas Tsintzas
- School of Life Sciences, Faculty of Medicine & Health Sciences, The University of Nottingham Medical School, Queen’s Medical Centre, Nottingham NG7 2UH, UK;
| | - Petra Kolic
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK; (D.T.); (P.K.); (G.O.-P.)
| | - Gladys Onambele-Pearson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK; (D.T.); (P.K.); (G.O.-P.)
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19
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Nichols S, McGregor G, Al-Mohammad A, Ali AN, Tew G, O'Doherty AF. The effect of protein and essential amino acid supplementation on muscle strength and performance in patients with chronic heart failure: a systematic review. Eur J Nutr 2020; 59:1785-1801. [PMID: 31659450 PMCID: PMC7351803 DOI: 10.1007/s00394-019-02108-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Critically low skeletal muscle mass and strength, observed in 20% of people with chronic heart failure (CHF), reduces functional capacity, quality of life (QoL) and survival. Protein and essential amino acid (EAA) supplementation could be a viable treatment strategy to prevent declines in muscle strength and performance, and subsequently improve QoL and survival. This systematic review (PROSPERO: CRD42018103649) aimed to assess the effect of dietary protein and/or EAA supplementation on muscle strength and performance in people with CHF. METHODS Searches of PubMed, MEDLINE and Embase identified studies that reported changes in strength or muscle performance following protein and/or EAA supplementation in patients with CHF. Following PRISMA guidelines and using predefined inclusion/exclusion criteria relating to participants, intervention, control, outcome and study design, two reviewers independently screened titles, abstracts and full manuscripts for eligibility. Risk of bias was assessed using Cochrane Risk of Bias Tool (RCTs) or Mixed Methods Appraisal Tool (cohort studies). Data were extracted for analysis using predefined criteria. RESULTS Five randomised controlled trials (RCT) and one cohort study met our inclusion criteria. All RCTs had a high risk of bias. The methodological quality of the cohort study was moderate. Heterogeneity of extracted data prevented meta-analyses, qualitative synthesis was therefore performed. Data from 167 patients with CHF suggest that protein and/or EAA supplementation does not improve strength, but may increase six-minute walk test distance, muscle mass and QoL. CONCLUSIONS The limited quality of the studies makes firm conclusions difficult, however protein and/or EAA supplementation may improve important outcome measures related to sarcopenia. High-quality randomised controlled studies are needed.
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Affiliation(s)
- Simon Nichols
- Centre for Sports and Exercise Science, Sheffield Hallam University, Collegiate Campus, Sheffield, S10 2BP, UK.
| | - Gordon McGregor
- Centre for Exercise and Health, Department of Cardiopulmonary Rehabilitation, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- School of Health and Life Sciences, Coventry University, Coventry, UK
| | | | - Ali N Ali
- Sheffield National Institute for Health Research Biomedical Research Centre, Glossop Road, Sheffield, UK
| | - Garry Tew
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, UK
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20
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Yamamoto K, Tsuchihashi-Makaya M, Kinugasa Y, Iida Y, Kamiya K, Kihara Y, Kono Y, Sato Y, Suzuki N, Takeuchi H, Higo T, Miyazawa Y, Miyajima I, Yamashina A, Yoshita K, Washida K, Kuzuya M, Takahashi T, Nakaya Y, Hasebe N, Tsutsui H. Japanese Heart Failure Society 2018 Scientific Statement on Nutritional Assessment and Management in Heart Failure Patients. Circ J 2020; 84:1408-1444. [PMID: 32655089 DOI: 10.1253/circj.cj-20-0322] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | | | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Yuki Iida
- Department of Rehabilitation Medicine, Kainan Hospital
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical & Health Sciences
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital
| | - Yukihito Sato
- Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki General Medical Center
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Harumi Takeuchi
- Department of Clinical Nutrition, Nagoya University Hospital
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Yasushi Miyazawa
- Department of Clinical Nutrition, Tokyo Medical University Hospital
| | - Isao Miyajima
- Department of Clinical Nutrition, Chikamori Hospital
| | | | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science
| | - Koichi Washida
- Faculty of Nursing, Kobe Women's University.,Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center
| | - Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University.,Department of Rehabilitation, Juntendo University Hospital
| | - Yutaka Nakaya
- Department of Internal Medicine, Touto Kasukabe Hospital
| | - Naoyuki Hasebe
- Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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21
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Hassanzadeh-Makoui R, Jamei M, Hassanzadeh-Makoui M, Khederlou H. Effects of Vitamin D on Left Ventricular Ejection Fraction in Patients with Systolic Heart Failure: A Double-Blind Randomized Clinical Trial. Int J Endocrinol Metab 2020; 18:e103528. [PMID: 33257907 PMCID: PMC7695351 DOI: 10.5812/ijem.103528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/02/2020] [Accepted: 08/22/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Heart failure is a pathophysiologic state in which the cardiac output is not able to supply the body with enough oxygen and nutrients. The prevalence of heart failure has increased dramatically over the last decades. Vitamin D levels in patients with chronic heart failure are lower than healthy controls, and vitamin D deficiency has a direct relationship with mortality. OBJECTIVES This study aimed to evaluate the effect of vitamin D on the improvement of left ventricular ejection fraction in patients with systolic heart failure. METHODS In this case-control clinical trial, 142 patients with chronic systolic heart failure were identified. Based on the inclusion and exclusion criteria, 114 patients were enrolled in the study and randomly divided into two groups. One group (n = 58) received 50,000 units of vitamin D capsules weekly for eight weeks, and the patients in the other group (n = 56) received a placebo. After excluding 15 patients from the placebo group and 17 patients from the intervention group during the study, according to the exclusion criteria, 41 patients were evaluated in both groups for ejection fraction changes after two months. RESULTS According to the results of this research, there were no statistically significant differences in the baseline parameters between the two studied groups. The intervention group consisted of 18 female and 23 male patients with a mean age of 61.68 ± 19.8 years. Moreover, the placebo group included 21 female and 20 male patients with a mean age of 62.12 ± 18.2 years. After a 2-month follow-up, the intervention group showed statistically significant changes in ejection fraction, end-diastolic volume, and heart failure class compared to the placebo group. Also, the serum level of albumin and vitamin D in the intervention group was significantly higher than the placebo group. CONCLUSIONS The results of this study show that vitamin D treatment can improve the ejection fraction and functional ability of patients with vitamin D deficiency. If more comprehensive studies support this hypothesis, vitamin D deficiency assessment and correction in patients with chronic heart failure may be recommended.
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Affiliation(s)
- Reza Hassanzadeh-Makoui
- Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maziar Jamei
- Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Masoud Hassanzadeh-Makoui
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamid Khederlou
- Resident of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Resident of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9125426158,
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22
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Abstract
The underlying mechanism for clinical and biochemical manifestations of chronic heart failure (HF) may be due in part to neurohumoral adaptations, such as activation of the renin-angiotensin-aldosterone and sympathetic nervous systems in the periphery and the brain. Internet search and discussion with colleagues are the methods for this study. Since chronic HF is associated with autonomic imbalance with increased sympathetic nerve activity and a withdrawal of parasympathetic activity, it may be considered a brain disease. This phenomenon may be the result of an increased systemic and cerebral angiotensin II signaling because plasma angiotensin II is increased in humans and animals with chronic HF. The increase in angiotensin II signaling enhances sympathetic nerve activity through actions on both central and peripheral sites during chronic HF. Activation of angiotensin II signaling in different brain sites such as the paraventricular nucleus (PVN), rostral ventrolateral medulla (RVLM), and area postrema (AP) may increase the release of norepinephrine, oxidative stress, and inflammation leading to increased cardiac contractility. It is possible that blocking angiotensin II type 1 receptors decreases sympathetic nerve activity and cardiac sympathetic afferent reflex when therapy is administered to the PVN. The administration of an angiotensin receptor blocker by injection into the AP activates the sympatho-inhibitory baroreflex indicating that receptor blockers act by increasing parasympathetic activity. In chronic HF, in peripheral regions, angiotensin II elevates both norepinephrine release and synthesis and inhibits norepinephrine uptake at nerve endings, which may contribute to the increase in sympathetic nerve activity. Increased circulating angiotensin II during chronic HF may enhance the sympatho-excitatory chemoreflex and inhibit the sympatho-inhibitory baroreflex resulting in worsening of HF. Increased circulating angiotensin II signaling can directly act on the central nervous system via the subfornical organ and the AP to increase sympathetic outflow resulting in to neurohumoral dysfunction, resulting in to heart failure.
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23
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Bomer N, Grote Beverborg N, Hoes MF, Streng KW, Vermeer M, Dokter MM, IJmker J, Anker SD, Cleland JGF, Hillege HL, Lang CC, Ng LL, Samani NJ, Tromp J, van Veldhuisen DJ, Touw DJ, Voors AA, van der Meer P. Selenium and outcome in heart failure. Eur J Heart Fail 2019; 22:1415-1423. [PMID: 31808274 PMCID: PMC7540257 DOI: 10.1002/ejhf.1644] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/09/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022] Open
Abstract
Aims Severe deficiency of the essential trace element selenium can cause myocardial dysfunction although the mechanism at cellular level is uncertain. Whether, in clinical practice, moderate selenium deficiency is associated with worse symptoms and outcome in patients with heart failure is unknown. Methods and results BIOSTAT‐CHF is a multinational, prospective, observational cohort study that enrolled patients with worsening heart failure. Serum concentrations of selenium were measured by inductively coupled plasma mass spectrometry. Primary endpoint was a composite of all‐cause mortality and hospitalization for heart failure; secondary endpoint was all‐cause mortality. To investigate potential mechanisms by which selenium deficiency might affect prognosis, human cardiomyocytes were cultured in absence of selenium, and mitochondrial function and oxidative stress were assessed. Serum selenium concentration (deficiency) was <70 μg/L in 485 (20.4%) patients, who were older, more often women, had worse New York Heart Association class, more severe signs and symptoms of heart failure and poorer exercise capacity (6‐min walking test) and quality of life (Kansas City Cardiomyopathy Questionnaire). Selenium deficiency was associated with higher rates of the primary endpoint [hazard ratio (HR) 1.23; 95% confidence interval (CI) 1.06–1.42] and all‐cause mortality (HR 1.52; 95% CI 1.26–1.86). In cultured human cardiomyocytes, selenium deprivation impaired mitochondrial function and oxidative phosphorylation, and increased intracellular reactive oxygen species levels. Conclusions Selenium deficiency in heart failure patients is independently associated with impaired exercise tolerance and a 50% higher mortality rate, and impaired mitochondrial function in vitro, in human cardiomyocytes. Clinical trials are needed to investigate the effect of selenium supplements in patients with heart failure, especially if they have low plasma concentrations of selenium.
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Affiliation(s)
- Nils Bomer
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Niels Grote Beverborg
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martijn F Hoes
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Koen W Streng
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mathilde Vermeer
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin M Dokter
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan IJmker
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stefan D Anker
- BIOSTAT-CHF.,Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen (UMG), Göttingen, Germany
| | - John G F Cleland
- BIOSTAT-CHF.,National Heart & Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, and University of Hull, Kingston-upon-Hull, UK
| | - Hans L Hillege
- BIOSTAT-CHF.,Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Chim C Lang
- BIOSTAT-CHF.,School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Leong L Ng
- BIOSTAT-CHF.,Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Nilesh J Samani
- BIOSTAT-CHF.,Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Jasper Tromp
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,National Heart Centre Singapore, Singapore
| | - Dirk J van Veldhuisen
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,BIOSTAT-CHF.,Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Daan J Touw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Adriaan A Voors
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,BIOSTAT-CHF.,Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter van der Meer
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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24
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Association between the Prognostic Nutritional Index and Dietary Intake in Community-Dwelling Older Adults with Heart Failure: Findings from NHANES III. Nutrients 2019; 11:nu11112608. [PMID: 31683657 PMCID: PMC6893765 DOI: 10.3390/nu11112608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 12/31/2022] Open
Abstract
The objective of this study was to examine the association between nutritional status and dietary intake in community-dwelling older adults with heart failure (HF). A cross-sectional analysis of NHANES III data was conducted. The analytic sample was comprised of n = 445 individuals aged 50+ years with congestive HF (54.4% male, 22.9% non-Hispanic Black, 43.8% low-income). Nutritional status was measured using the Prognostic Nutritional Index (PNI). Participants were classified by PNI quintiles with lower PNI scores indicating lower nutritional status. Participants in quintile 5 showed significantly greater intakes of energy, protein, vegetables, magnesium, zinc, copper, potassium, red meat, saturated fat, and sodium. In multivariate analyses, increased intake of red meat (β = 0.253, p = 0.040) and vegetables (β = 0.255, p = 0.038) was associated with significantly better nutritional status. In the absence of comprehensive nutritional guidance for HF patients, it appears that small increases in energy, protein (red meat), and vegetable consumption are associated with improved nutritional status.
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25
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Turan B. A Brief Overview from the Physiological and Detrimental Roles of Zinc Homeostasis via Zinc Transporters in the Heart. Biol Trace Elem Res 2019; 188:160-176. [PMID: 30091070 DOI: 10.1007/s12011-018-1464-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022]
Abstract
Zinc (mostly as free/labile Zn2+) is an essential structural constituent of many proteins, including enzymes in cellular signaling pathways via functioning as an important signaling molecule in mammalian cells. In cardiomyocytes at resting condition, intracellular labile Zn2+ concentration ([Zn2+]i) is in the nanomolar range, whereas it can increase dramatically under pathological conditions, including hyperglycemia, but the mechanisms that affect its subcellular redistribution is not clear. Therefore, overall, very little is known about the precise mechanisms controlling the intracellular distribution of labile Zn2+, particularly via Zn2+ transporters during cardiac function under both physiological and pathophysiological conditions. Literature data demonstrated that [Zn2+]i homeostasis in mammalian cells is primarily coordinated by Zn2+ transporters classified as ZnTs (SLC30A) and ZIPs (SLC39A). To identify the molecular mechanisms of diverse functions of labile Zn2+ in the heart, the recent studies focused on the discovery of subcellular localization of these Zn2+ transporters in parallel to the discovery of novel physiological functions of [Zn2+]i in cardiomyocytes. The present review summarizes the current understanding of the role of [Zn2+]i changes in cardiomyocytes under pathological conditions, and under high [Zn2+]i and how Zn2+ transporters are important for its subcellular redistribution. The emerging importance and the promise of some Zn2+ transporters for targeted cardiac therapy against pathological stimuli are also provided. Taken together, the review clearly outlines cellular control of cytosolic Zn2+ signaling by Zn2+ transporters, the role of Zn2+ transporters in heart function under hyperglycemia, the role of Zn2+ under increased oxidative stress and ER stress, and their roles in cancer are discussed.
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Affiliation(s)
- Belma Turan
- Department of Biophysics, Faculty of Medicine, Ankara University, Ankara, Turkey.
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26
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Siriwardhane T, Krishna K, Devarajan K, Ranganathan V, Jayaraman V, Wang T, Bei K, Rajasekaran JJ, Krishnamurthy H. Insights into cardiovascular risk and nutritional status in subjects with wheat-related disorders. Biomarkers 2019; 24:303-307. [PMID: 30734586 DOI: 10.1080/1354750x.2019.1578829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Wheat-related disorders are a spectrum of disorders associated with different autoimmune and non-autoimmune diseases. However, it is unclear whether these wheat-related disorders lead to adverse health effects such as cardiovascular risk, nutritional deficiencies etc. The objective of the study was to explore the lipid profiles and the nutritional status of subjects with wheat-related disorders to understand the potential threat of wheat on cardiovascular risk and nutritional deficiency. Method: A total of 1041 subjects who showed wheat-related symptoms were initially tested for the wheat protein antibody panel (Wheat Zoomer (WZ) panel and Coeliac Disease (CD) panel), then for cardiovascular panel and the micronutrient panel at Vibrant America Clinical Laboratory. Results: Subjects with both Wheat Zoomer positivity (WZ+) and Coeliac Disease positivity (CD+) had significantly low levels of high-density lipoproteins (HDL) (279/483(57.8%) and 29/47(61.7%) respectively), but only subjects with WZ + had low levels of Apo A1 (44/424(9.5%)), and high levels of Omega 6 fatty acids (53/334(15.9%)). None of the micronutrients tested showed a significant imbalance in WZ + subjects. Conclusion: Subjects with positive serology for WZ have deranged blood lipid profiles but did not show any significant micronutrient deficiency. Hence, our results showcase a significant association of wheat-related disorders to cardiovascular risk.
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Affiliation(s)
| | | | | | | | | | | | - Kang Bei
- b Vibrant Sciences LLC , San Carlos , CA , USA
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27
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Jensen ASC, Polcwiartek C, Søgaard P, Mortensen RN, Davidsen L, Aldahl M, Eriksen MA, Kragholm K, Torp-Pedersen C, Hansen SM. The Association Between Serum Calcium Levels and Short-Term Mortality in Patients with Chronic Heart Failure. Am J Med 2019; 132:200-208.e1. [PMID: 30691552 DOI: 10.1016/j.amjmed.2018.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with chronic heart failure have vulnerable myocardial function and are susceptible to electrolyte disturbances. In these patients, diuretic treatment is frequently prescribed, though it is known to cause electrolyte disturbances. Therefore, we investigated the association between altered calcium homeostasis and the risk of all-cause mortality in chronic heart failure patients. METHODS From Danish national registries, we identified patients with chronic heart failure with a serum calcium measurement within a minimum 90 days after initiated treatment with both loop diuretics and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Patients were divided into 3 groups according to serum calcium levels, and Cox regression was used to assess the mortality risk of <1.18 mmol/L (hypocalcemia) and >1.32 mmol/L (hypercalcemia) compared with 1.18 mmol/L-1.32 mmol/L (normocalcemia) as reference. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. RESULTS Of 2729 patients meeting the inclusion criteria, 32.6% had hypocalcemia, 63.1% normocalcemia, and 4.3% hypercalcemia. The highest mortality risk was present in early deaths (≤30 days), with a HR of 2.22 (95% CI; 1.74-2.82) in hypocalcemic patients and 1.67 (95% CI; 0.96-2.90) in hypercalcemic patients compared with normocalcemic patients. As for late deaths (>30 days), a HR of 1.52 (95% CI; 1.12-2.05) was found for hypocalcemic patients and a HR of 1.87 (95% CI; 1.03-3.41) for hypercalcemic patients compared with normocalcemic patients. In adjusted analyses, hypocalcemia and hypercalcemia remained associated with an increased mortality risk in both the short term (≤30 days) and longer term (>30 days). CONCLUSION Altered calcium homeostasis was associated with an increased short-term mortality risk. Almost one-third of all the heart failure patients suffered from hypocalcemia, having a poor prognosis.
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Affiliation(s)
| | - Christoffer Polcwiartek
- Department of Cardiology, Aalborg University Hospital, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark
| | - Peter Søgaard
- Department of Cardiology and Clinical Medicine Center for Cardiovascular Research, Aalborg University Hospital, Denmark
| | | | - Line Davidsen
- Department of Cardiology, Aalborg University Hospital, Denmark
| | - Mette Aldahl
- Department of Cardiology, Aalborg University Hospital, Denmark
| | | | - Kristian Kragholm
- Department of Cardiology, Aalborg University Hospital, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark; Department of Cardiology, Vendsyssel Regional Hospital, Hjørring, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark
| | - Steen Møller Hansen
- Department of Cardiology, Aalborg University Hospital, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark
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28
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Yilmaz MS, Şakiyan Ö, Barutcu Mazi I, Mazi BG. Phenolic content and some physical properties of dried broccoli as affected by drying method. FOOD SCI TECHNOL INT 2018; 25:76-88. [PMID: 30205717 DOI: 10.1177/1082013218797527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Broccoli samples ( Brassica oleracea) with an initial moisture content of 82.87% (wb) were dried using microwave technology (18, 36, and 54 W/g). Convective drying was used as a control group. The dependent variables investigated in the study were phenolic content, color, rehydration capacity, and microstructure of broccoli samples. Moreover, the best fitting thin layer model to the experimental moisture ratio was determined. The phenolic contents were found as 892.4, 740.6, and 759.8 mg gallic acid/100 g dry matter for fresh, convective dried, and microwave (MW) dried at 54 W/g broccoli samples, respectively. The total phenolic content of samples dried at 54 W/g was closest to fresh samples compared to other MW power intensities and convective drying. A similar result was obtained for color values too. L*, a*, and b* of microwave-dried samples at 54 W/g were comparable to fresh broccoli. Another important result obtained from the study was the insignificant effect of drying conditions on rehydration capacity. In addition, it was found that microwave power had a positive effect on drying time; as the microwave powers applied were compared, the shortest drying time was reached at 54 W/g. When the process durations of microwave drying and convective drying were compared, it can be reported that a much lower process time for microwave drying was obtained with respect to convective drying. Drying in microwave oven has reduced the drying time by 49-52%. In the light of the results obtained, it may be declared that it is possible to produce high-quality dried broccoli samples in a very short time by using microwave drying at 54 W/g.
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Affiliation(s)
- Merve Sılanur Yilmaz
- 1 Department of Food Engineering, Ankara University, Ankara, Turkey.,2 Department of Food Engineering, Bitlis Eren University, Bitlis, Turkey
| | - Özge Şakiyan
- 1 Department of Food Engineering, Ankara University, Ankara, Turkey
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29
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Affiliation(s)
- Thomas M. Cascino
- Michigan Medicine Frankel Cardiovascular CenterUniversity of MichiganAnn ArborMI
| | - Scott L. Hummel
- Michigan Medicine Frankel Cardiovascular CenterUniversity of MichiganAnn ArborMI
- Ann Arbor Veterans Affairs Health SystemAnn ArborMI
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30
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Vitamin D deficiency is an independent predictor of mortality in patients with chronic heart failure. Eur J Nutr 2018; 58:2535-2543. [PMID: 30121806 PMCID: PMC6689317 DOI: 10.1007/s00394-018-1806-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/02/2018] [Indexed: 01/14/2023]
Abstract
Purpose Low 25-hydroxyvitamin D (25[OH]D) concentrations have been associated with adverse outcomes in selected populations with established chronic heart failure (CHF). However, it remains unclear whether 25[OH]D deficiency is associated with mortality and hospitalisation in unselected patients receiving contemporary medical and device therapy for CHF. Methods We prospectively examined the prevalence and correlates of 25[OH]D deficiency in 1802 ambulatory patients with CHF due to left ventricular systolic dysfunction (left ventricular ejection fraction ≤ 45%) attending heart failure clinics in the north of England. Results 73% of patients were deficient in 25[OH]D (< 50 nmol/L). 25[OH]D deficiency was associated with male sex, diabetes, lower serum sodium, higher heart rate, and greater diuretic requirement. During a mean follow-up period of 4 years, each 2.72-fold increment in 25[OH]D concentration (for example from 32 to 87 nmol/L) is associated with 14% lower all-cause mortality (95% confidence interval (CI) 1, 26%; p = 0.04), after accounting for potential confounding factors. Conclusions Low 25-hydroxyvitamin D deficiency is associated with increased mortality in patients with chronic heart failure due to left ventricular systolic dysfunction. Whether vitamin D supplementation will improve outcomes is, as yet, unproven. Electronic supplementary material The online version of this article (10.1007/s00394-018-1806-y) contains supplementary material, which is available to authorized users.
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QTL Mapping of Genome Regions Controlling Manganese Uptake in Lentil Seed. G3-GENES GENOMES GENETICS 2018; 8:1409-1416. [PMID: 29588380 PMCID: PMC5940135 DOI: 10.1534/g3.118.200259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study evaluated Mn concentration in the seeds of 120 RILs of lentil developed from the cross “CDC Redberry” × “ILL7502”. Micronutrient analysis using atomic absorption spectrometry indicated mean seed manganese (Mn) concentrations ranging from 8.5 to 26.8 mg/kg, based on replicated field trials grown at three locations in Turkey in 2012 and 2013. A linkage map of lentil was constructed and consisted of seven linkage groups with 5,385 DNA markers. The total map length was 973.1 cM, with an average distance between markers of 0.18 cM. A total of 6 QTL for Mn concentration were identified using composite interval mapping (CIM). All QTL were statistically significant and explained 15.3–24.1% of the phenotypic variation, with LOD scores ranging from 3.00 to 4.42. The high-density genetic map reported in this study will increase fundamental knowledge of the genome structure of lentil, and will be the basis for the development of micronutrient-enriched lentil genotypes to support biofortification efforts.
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Association of Serum Zinc Level With Prognosis in Patients With Heart Failure. J Card Fail 2018; 24:375-383. [PMID: 29501920 DOI: 10.1016/j.cardfail.2018.02.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/10/2018] [Accepted: 02/23/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF). METHODS AND RESULTS We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc <75, n = 322), and third (zinc <62, n = 323) tertiles. We examined cardiac function and exercise capacity and followed up on all patients. Although cardiac function did not differ among the 3 groups, peak oxygen consumption was significantly lower in the third tertile than in the first and second tertiles (peak oxygen consumption, 14.2 vs 15.9 and 15.2 mL/kg/min, P = .010). In the Kaplan-Meier analysis (mean duration of follow-up 1103 days), cardiac and all-cause mortality was highest in the third tertile compared with the first and second tertiles. In the Cox proportional hazard analysis, serum zinc level was a predictor of cardiac and all-cause mortality. In the subgroup analysis, there were no interactions concerning associations between serum zinc levels with prognosis and other important variables, including age, gender, comorbidities, medications, other micronutrient levels, B-type natriuretic peptide, and left ventricular ejection fraction. The associations between zinc levels with mortality were consistent in all subgroups. CONCLUSION Decreased serum zinc levels are associated with high mortality, accompanied by impaired exercise capacity.
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Patel P, Smith F, Kilcullen N, Artis N. Dilated cardiomyopathy as the first presentation of coeliac disease: association or causation? Clin Med (Lond) 2018; 18:177-179. [PMID: 29626026 PMCID: PMC6303458 DOI: 10.7861/clinmedicine.18-2-177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Global ventricular impairment is a frequent presentation in clinical practice, but dissection of causative mechanisms from clinical associations is challenging. We present the case of a 19-year-old man who presented with dilated cardiomyopathy as the first presentation of coeliac disease. The manifestation of iron deficiency anaemia prompted gastroenterology input and enabled accurate diagnosis. It is unclear whether coeliac disease was simply coexistent or directly implicated in pathophysiology. Mechanisms may relate to nutritional deficiencies or autoimmune myocarditis arising from cross-reactivity. We advocate early multidisciplinary involvement in such contexts to aid with management strategy. Despite adherence to a gluten-free diet, ventricular dysfunction persisted and he has been referred to a cardiac transplant centre.
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Eshak ES, Iso H, Yamagishi K, Maruyama K, Umesawa M, Tamakoshi A. Associations between copper and zinc intakes from diet and mortality from cardiovascular disease in a large population-based prospective cohort study. J Nutr Biochem 2018. [PMID: 29529560 DOI: 10.1016/j.jnutbio.2018.02.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several studies have related cardiovascular disease (CVD) to serum concentrations of copper and zinc but not to their dietary intakes. We thought to examine the association between dietary intakes of copper and zinc with risk of mortality from CVD in a prospective study encompassing 58,646 healthy Japanese men and women aged 40-79 years. The intakes of copper and zinc were determined by a validated self-administered food frequency questionnaire, and their associations with risk of mortality from CVD were evaluated by Cox proportional hazard modelling. During 965, 970 person-years of follow-up between 1989-2009, we documented 3,388 CVD deaths [1,514 from stroke, 702 from coronary heart disease (CHD) and 1,172 from other CVD]. Copper intake was not associated with CHD mortality; however, the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality from stroke, other CVD and total CVD in the highest versus the lowest quintiles of copper intake among men were 1.78 (1.16-2.77; P-trend=0.007), 1.61 (1.01-2.81; P-trend =0.03) and 1.63 (1.21-2.33; P-trend=0.001), respectively, and those among women were 1.49 (1.00-2.19; P-trend=0.04), 1.59 (1.09-2.55; P-trend =0.02) and 1.36 (1.06-1.69; P-trend=0.01), respectively. Higher intakes of zinc was inversely associated with mortality from CHD in men; 0.68 (0.58-1.03; P-trend=0.05) but not women; 1.13 (0.71- 1.49; P-trend=0.61). No associations were observed with other mortality endpoints. In conclusion, dietary copper intake was positively associated with mortality from CVD in both genders; whereas, higher dietary zinc intake was inversely associated with mortality from CHD in men but not women.
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Affiliation(s)
- Ehab S Eshak
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita Shi, Osaka 565-0871, Japan; Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Shalaby land, Minia, 61511, Egypt.
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita Shi, Osaka 565-0871, Japan.
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan.
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
| | - Akiko Tamakoshi
- Public Health, Department of Social Medicine, Graduate School of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
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Wleklik M, Uchmanowicz I, Jankowska-Polańska B, Andreae C, Regulska-Ilow B. The Role of Nutritional Status in Elderly Patients with Heart Failure. J Nutr Health Aging 2018; 22:581-588. [PMID: 29717757 DOI: 10.1007/s12603-017-0985-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Evidence indicates that malnutrition very frequently co-occurs with chronic heart failure (HF) and leads to a range of negative consequences. Studies show associations between malnutrition and wound healing disorders, an increased rate of postoperative complications, and mortality. In addition, considering the increasing age of patients with HF, a specific approach to their treatment is required. Guidelines proposed by the European Society of Cardiology (ESC) for treating acute and chronic HF refer to the need to monitor and prevent malnutrition in HF patients. However, the guidelines feature no strict nutritional recommendations for HF patients, who are at high nutritional risk as a group, nor do they offer any such recommendations for the poor nutritional status subgroup, for which high morbidity and mortality rates have been observed. In the context of multidisciplinary healthcare, recommended by the ESC and proven by research to offer multifaceted benefits, nutritional status should be systematically assessed in HF patients. Malnutrition has become a challenge within healthcare systems and day-to-day clinical practice, especially in developed countries, where it affects the course of disease and patients' prognosis.
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Affiliation(s)
- M Wleklik
- Izabella Uchmanowicz, Wroclaw Medical University, Wroclaw, Lower Silesia Poland,
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Mohammadifard N, Humphries KH, Gotay C, Mena-Sánchez G, Salas-Salvadó J, Esmaillzadeh A, Ignaszewski A, Sarrafzadegan N. Trace minerals intake: Risks and benefits for cardiovascular health. Crit Rev Food Sci Nutr 2017; 59:1334-1346. [PMID: 29236516 DOI: 10.1080/10408398.2017.1406332] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Minerals play a major role in regulating cardiovascular function. Imbalances in electrolyte minerals are frequent and potentially hazardous occurrences that may lead to the development of cardiovascular diseases (CVDs). Transition metals, such as iron, zinc, copper and selenium, play a major role in cell metabolism. However, there is controversy over the effects of dietary and supplemental intake of these metals on cardiovascular risk factors and events. Since their pro-oxidant or antioxidant functions can have different effects on cardiovascular health. While deficiency of these trace elements can cause cardiovascular dysfunction, several studies have also shown a positive association between metal serum levels and cardiovascular risk factors and events. Thus, a J- or U-shaped relationship between the transition minerals and cardiovascular events has been proposed. Given the existing controversies, large, well-designed, long-term, randomized clinical trials are required to better examine the effects of trace mineral intake on cardiovascular events and all-cause mortality in the general population. In this review, we discuss the role of dietary and/or supplemental iron, copper, zinc, and selenium on cardiovascular health. We will also clarify their clinical applications, benefits, and harms in CVDs prevention.
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Affiliation(s)
- Noushin Mohammadifard
- a Hypertension Research Center , Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran.,b Interventional Cardiology Research Center , Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Karin H Humphries
- c Women's Cardiovascular Health , Department of Medicine, The University of British Columbia , Vancouver , Canada
| | - Carolyn Gotay
- d Centre of Excellence in Cancer Prevention, Faculty of Medicine, School of Population and Public Health, The University of British Columbia , Vancouver , Canada
| | - Guillermo Mena-Sánchez
- e Human Nutrition Unit , Department of Biochemistry & Biotechnology , IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition , Reus , Spain
| | - Jordi Salas-Salvadó
- e Human Nutrition Unit , Department of Biochemistry & Biotechnology , IISPV, School of Medicine, Rovira i Virgili University, and CIBER Obesity and Nutrition , Reus , Spain
| | - Ahmad Esmaillzadeh
- f Obesity and Eating Habits Research Center , Endocrinology and Metabolism Molecular, Cellular Sciences Institute, Tehran University of Medical Sciences , Tehran , Iran.,g Department of Community Nutrition , School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran.,h Department of Community Nutrition , School of Nutrition and Food Science, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Andrew Ignaszewski
- i Division of Cardiology, Faculty of Medicine, The University of British Columbia , Vancouver , Canada
| | - Nizal Sarrafzadegan
- j Isfahan Cardiovascular Research Center , Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran
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Ozyıldırım S, Baltaci AK, Sahna E, Mogulkoc R. Effects of Chronic and Acute Zinc Supplementation on Myocardial Ischemia-Reperfusion Injury in Rats. Biol Trace Elem Res 2017; 178:64-70. [PMID: 27909864 DOI: 10.1007/s12011-016-0903-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
The present study aims to explore the effects of chronic and acute zinc sulfate supplementation on myocardial ischemia-reperfusion injury in rats. The study registered 50 adult male rats which were divided into five groups in equal numbers as follows: group 1, normal control; group 2, sham; group 3, myocardial ischemia reperfusion (My/IR): the group which was fed on a normal diet and in which myocardial I/R was induced; group 4, myocardial ischemia reperfusion + chronic zinc: (5 mg/kg i.p. zinc sulfate for 15 days); and group 5, myocardial ischemia reperfusion + acute zinc: the group which was administered 15 mg/kg i.p. zinc sulfate an hour before the operation and in which myocardial I/R was induced. The collected blood and cardiac tissue samples were analyzed using spectrophotometric method to determine levels of MDA, as an indicator of tissue injury, and GSH, as an indicator of antioxidant activity. The highest plasma and heart tissue MDA levels were measured in group 3 (p < 0.05). Group 5 had lower MDA values than group 3, while group 4 had significantly lower MDA values than groups 3 and 5 (p < 0.05). The highest erythrocyte GSH values were found in group 4 (p < 0.05). Erythrocyte GSH values in group 5 were higher than those in group 3 (p < 0.05). The highest GSH values in heart tissue were measured in group 4 (p < 0.05). The results of the study reveal that the antioxidant activity inhibited by elevated oxidative stress in heart ischemia reperfusion in rats is restored partially by acute zinc administration and markedly by chronic zinc supplementation.
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Affiliation(s)
| | | | - Engin Sahna
- Medical Faculty, Department of Pharmacology, Firat University, Elazıg, Turkey
| | - Rasim Mogulkoc
- Medical Faculty, Department of Physiology, Selcuk University, 42031, Konya, Turkey
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Price RJG, Witham MD, McMurdo MET. Defining the nutritional status and dietary intake of older heart failure patients. Eur J Cardiovasc Nurs 2016; 6:178-83. [PMID: 17049926 DOI: 10.1016/j.ejcnurse.2006.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Accepted: 08/17/2006] [Indexed: 12/25/2022]
Abstract
Background Little information exists about diet in the management of heart failure. Aims To describe the nutritional and biochemical status, and the dietary intake of older heart failure patients. Methods Stable outpatients and patients with recent hospitalisation for decompensated heart failure were recruited. Anthropometric measurements, handgrip strength, biochemical values and echocardiography were recorded. Patients kept 7-day food diaries and completed questionnaires concerning food provision. Results Forty-five patients with a mean (S.D.) age of 80.8 (6.8) years were studied and classed according to the New York Heart Association (NYHA) (11% Class I, 27% Class II and 62% Class III). Mean (S.D.) body mass index (BMI) was 27.1 (5.4) kg/m2 with 7% of patients having a BMI<20 kg/m2 and 56% with a BMI above 25 kg/m2. 64% of participants failed to achieve the estimated average requirements for energy intake; 82% took more than 2 mg of sodium daily; and 18% had a potassium intake above 3500 mg/day. Only 29% of individuals did not need assistance with food shopping, whilst 58% required assistance with meal preparation. Conclusion Possible targets for dietary intervention in older heart failure patients have been identified but whether such changes would be beneficial to patients is unknown.
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Affiliation(s)
- Rosemary J G Price
- Section of Ageing and Health, Division of Medicine and Therapeutics, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
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Lahey MD, Kamel AY. Thiamin, Pyridoxine, Vitamin D, and Carotene Deficiency in a Malnourished Patient Following Billroth II Gastrectomy. Nutr Clin Pract 2016; 32:271-274. [PMID: 27810990 DOI: 10.1177/0884533616675594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We describe the case of a malnourished 48-year-old man who had previously undergone a Billroth II procedure for severe peptic ulcer disease. He was found to have a severely stenotic gastrojejunal anastomosis with inflamed mucosa that prevented him from tolerating solid food. Laboratory assessment revealed deficiencies in thiamin, pyridoxine, vitamin D, and carotene. This case demonstrates potential vital micronutrient complications following a partial gastrectomy.
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Affiliation(s)
- Mark D Lahey
- 1 Department of Pharmacy, UF Health Shands Hospital, Gainesville, Florida, USA
| | - Amir Y Kamel
- 1 Department of Pharmacy, UF Health Shands Hospital, Gainesville, Florida, USA
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Kkeveetil CV, Thomas G, Chander SJU. Role of micronutrients in congestive heart failure: A systematic review of randomized controlled trials. Tzu Chi Med J 2016; 28:143-150. [PMID: 28757745 PMCID: PMC5442906 DOI: 10.1016/j.tcmj.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/20/2016] [Accepted: 08/23/2016] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To assess the effect of micronutrients on health outcomes in patients with heart failure. MATERIALS AND METHODS Only randomized controlled trials testing the effectiveness of different micronutrients either singly or combined versus placebo in heart failure patients were included. We conducted a search in different databases such as Medline from PubMed, Embase and Scopus from Elsevier, and Google Scholar. The keywords used in the search were "Heart Failure" and its cognates, "Micronutrient," "Minerals," and names of individual micronutrients. RESULTS Out of 3288 titles and abstracts reviewed, only 11 trials comprising 529 individuals were found to be appropriate to be included in the final review. It was found that micronutrients, either single or combined, improved the health outcomes of heart failure patients by improving exercise tolerance, functional capacity, left ventricular function, flow-dependent dilation, and inflammatory milieu, thereby improving the quality of life of health failure patients. Certain micronutrients also normalized endothelial dysfunction. CONCLUSION Overall, this systematic review found sufficient evidence to support a large-scale trial on micronutrient supplementation in patients with heart failure.
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Affiliation(s)
| | - Grace Thomas
- KG Hospital and Postgraduate Research Institute, Coimbatore, India
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Du Q, Yao H, Yao L, Zhang Z, Lei X, Xu S. Selenium Deficiency Influences the Expression of Selenoproteins and Inflammatory Cytokines in Chicken Aorta Vessels. Biol Trace Elem Res 2016; 173:501-13. [PMID: 27025720 DOI: 10.1007/s12011-016-0676-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/14/2016] [Indexed: 01/26/2023]
Abstract
Selenium deficiency is known to cause cardiovascular diseases. However, the role of Se deficiency in causing oxidative damage and inflammation injury to the aorta vessels of chickens is not well known. In the present study, 180 1-day-old chickens were randomly divided into two groups, a low-Se group (L group) and a control-Se group (C group). The messenger RNA (mRNA) levels of 25 selenoproteins, the mRNA and protein expression levels of inflammatory cytokines (including NF-κB, TNF-α, COX-2, and PTGES), and the antioxidant levels in chicken aorta vessels were examined. The results showed that the mRNA levels of 25 selenoproteins and the activity of Gpx were decreased, while the mRNA and protein expression levels of inflammatory cytokines and the MDA content were increased by Se deficiency in chicken aorta vessels. The data from the present study indicated that Se deficiency decreases the expression of selenoproteins, reduces antioxidant function, and increases the expression of inflammatory factors in chicken aorta vessels.
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Affiliation(s)
- Qiang Du
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China
| | - Haidong Yao
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China
| | - Linlin Yao
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China
| | - Ziwei Zhang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China
| | - Xingen Lei
- College of Food Science and Nutrition Engineering, China Agricultural University, Beijing, People's Republic of China.
- Department of Animal Science, Cornell University, Ithaca, NY, USA.
| | - Shiwen Xu
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, 150030, People's Republic of China.
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Sciatti E, Lombardi C, Ravera A, Vizzardi E, Bonadei I, Carubelli V, Gorga E, Metra M. Nutritional Deficiency in Patients with Heart Failure. Nutrients 2016; 8:E442. [PMID: 27455314 PMCID: PMC4963918 DOI: 10.3390/nu8070442] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 01/06/2023] Open
Abstract
Heart failure (HF) is the main cause of mortality and morbidity in Western countries. Although evidence-based treatments have substantially improved outcomes, prognosis remains poor with high costs for health care systems. In patients with HF, poor dietary behaviors are associated with unsatisfactory quality of life and adverse outcome. The HF guidelines have not recommended a specific nutritional strategy. Despite the role of micronutrient deficiency, it has been extensively studied, and data about the efficacy of supplementation therapy in HF are not supported by large randomized trials and there is limited evidence regarding the outcomes. The aim of the present review is to analyze the state-of-the-art of nutritional deficiencies in HF, focusing on the physiological role and the prognostic impact of micronutrient supplementation.
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Affiliation(s)
- Edoardo Sciatti
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Carlo Lombardi
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Alice Ravera
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Enrico Vizzardi
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Ivano Bonadei
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Valentina Carubelli
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Elio Gorga
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, Brescia 25123, Italy.
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Douglas Y. The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine. Med Hypotheses 2016; 90:14-8. [PMID: 27063078 DOI: 10.1016/j.mehy.2016.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
Marcel Proust, author of À La Recherche du Temps Perdu, was considered a hypochondriac not only by the numerous specialists he consulted during his lifetime but also by every literary critic who ventured an opinion on his health, among them several clinicians. However, Proust's voluminous correspondence, as detailed in its attention to his every symptom as his novel, provides valuable clues to Proust's real, organic, and rare illness. Proust, in fact, was not only genuinely ill but far sicker than he even he believed, most likely suffering from the vascular subtype of Ehlers-Danlos Syndrome. Ironically, Proust's own doctors and his clinician-critics replicated the same kinds of diagnostic errors clinicians still routinely make today, shedding light on the plight of patients with rare illnesses.
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Affiliation(s)
- Yellowlees Douglas
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL 32611-7150, USA.
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Hemati F, Rahmani A, Asadollahi K, Soleimannejad K, Khalighi Z. Effects of Complementary Creatine Monohydrate and Physical Training on Inflammatory and Endothelial Dysfunction Markers Among Heart Failure Patients. Asian J Sports Med 2016; 7:e28578. [PMID: 27217930 PMCID: PMC4870830 DOI: 10.5812/asjsm.28578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/21/2015] [Accepted: 05/19/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF). OBJECTIVES The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients. PATIENTS AND METHODS One hundred patients were prospectively randomized into two groups: Intervention group which received 5 grams/day creatine monohydrate and exercised for 8 weeks; and control group which did not receive any interventions. Interleukine-6 (IL-6), high sensitivity C reactive protein (hs-CRP), P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at the start and end of the study for both groups. RESULTS In total, 100 patients including 50 controls and 50 intervention group (54% male, mean EF of 34.2 ± 10.5% and 52% male, mean EF of 35.6 ± 12.7%, respectively) were analyzed. The serum levels of hs-CRP and IL-6 increased at the end of the study in the control group compared to the baseline, (7.5 ± 1.5 mg/L vs. 6.9 ± 1.3 mg/L, P < 0.05 and 3.0 ± 0.75 ng/L vs. 2.55 ± 0.9 ng/L, P < 0.05, respectively). However, compared to the baseline, the level of both markers decreased at the end of the study in the intervention group (6.3 ± 1.6 mg/L vs.7.5 ± 1.5 mg/L, P < 0.05 and 2.1 ± 0.8 ng/L vs.2.5 ± 0.5 ng/L, P < 0.05). Also, P-selectin and ICAM-1 levels increased at the end of study (56.9 ± 1.8 ng/L vs. 51.9 ± 1.5 ng/L, P < 0.05 and 368.1 ± 25.4 µg/L vs. 353.1 ± 10.4 µg/L, P < 0.05 respectively). Inversely, the levels of these markers decreased in the intervention group, at the end of study (49.7 ± 1.9 ng/l vs. 51.4 ± 2.1 ng/l, P < 0.05 and 342.7 ± 16.5 µg/l vs. 350.4 ± 14.7 µg/l, P < 0.05, respectively). VCAM-1 level was not decreased significantly at the end of the study in the intervention group (570.5 ± 78.4 µg/L vs. 575.3 ± 86.5 µg/L, P > 0.05). CONCLUSIONS Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients.
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Affiliation(s)
- Farajollah Hemati
- Department of Sports Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Asghar Rahmani
- Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Khairollah Asadollahi
- Department of Epidemiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Koroush Soleimannejad
- Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Zahra Khalighi
- Department of Internal Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
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Abstract
There is growing awareness of the role of diet in both health and disease management. Much data are available on the cardioprotective diet in the primary and secondary prevention of CVD. However, there is limited information on the role of diet in the management of heart failure (HF). Animal models of HF have provided interesting insight and potential mechanisms by which dietary manipulation may improve cardiac performance and delay the progression of the disease, and small-scale human studies have highlighted beneficial diet patterns. The aim of this review is to summarise the current data available on the role of diet in the management of human HF and to demonstrate that dietary manipulation needs to progress further than the simple recommendation of salt and fluid restriction.
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Sofi NU, Raja W, Dar IA, Kasana B, Latief M, Arshad F, Hussain M, Irfan H, Parray M, Iqbal K. Role of thiamine supplementation in patients with heart failure – An Indian perspective. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jicc.2015.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jefferson K, Ahmed M, Choleva M, Mak S, Allard JP, Newton GE, Arcand J. Effect of a Sodium-Restricted Diet on Intake of Other Nutrients in Heart Failure: Implications for Research and Clinical Practice. J Card Fail 2015; 21:959-62. [PMID: 26497756 DOI: 10.1016/j.cardfail.2015.10.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/13/2015] [Accepted: 10/13/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Sodium restriction is the primary dietary therapy for heart failure (HF) patients. Currently, it is unknown if changing diets to reduce dietary sodium in HF causes secondary changes to the intake of other nutrients in this patient population already at nutritional risk. METHODS AND RESULTS HF patients (n = 16; 52 ± 12 years old; 78% male) followed a sodium-restricted diet for 1 week. Nutritional changes were documented at baseline and after a <2,000 mg/d sodium-restricted diet, as measured by food records before baseline and each day during the study. After a 49% reduction in dietary sodium (3,626 ± 956 to 1,785 ± 696 mg/d), we observed a significant reduction in calorie (2,467 ± 748 to 1,931 ± 388 kcal/d; P < .016), carbohydrate (293 ± 108 to 232 ± 56 g/d; P = .013), calcium (995 ± 496 to 609 ± 208 mg/d; P < .004), thiamine (2.0 ± 0.8 to 1.5 ± 0.8 mg/d; P = .020), and folate (412 ± 192 to 331 ± 172 μg/d; P = .019) intakes. There was a decrease in saturated fat (32 ± 18 to 21 ± 6 g/d; P = .032) and a trend to lower total fat (89 ± 34 to 68 ± 19 g/d; P = .066) and higher potassium (1,262 ± 328 to 1,405 ± 268 mg/1,000 kcal; P = .055) intakes. CONCLUSIONS We found multiple unintentional nutritional consequences with dietary sodium reduction in HF patients. These findings highlight the need to consider the whole diet when counseling HF patients to lower sodium intake.
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Affiliation(s)
- Katherine Jefferson
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Marlene Choleva
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Johane P Allard
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Gary E Newton
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - JoAnne Arcand
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
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Shetty PM, Hauptman PJ, Landfried LK, Patel K, Weiss EP. Micronutrient Deficiencies in Patients With Heart Failure: Relationships With Body Mass Index and Age. J Card Fail 2015; 21:968-72. [PMID: 26456043 DOI: 10.1016/j.cardfail.2015.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND It is conceivable that lean patients (body mass index 18.5-24.9 kg/m(2)) with heart failure (HF) have low body weight due to low food consumption and that this may contribute to micronutrient deficiencies and to their poorer prognosis compared with overweight/obese patients. We hypothesized that lean patients have a greater number of inadequate micronutrient intakes (<50% of recommendations) than overweight/obese patients and that this also depends on age. METHODS AND RESULTS Lean (n = 15) and overweight/obese (n = 49) patients underwent 24-hour diet and physical activity recall interviews. Inadequate essential micronutrient intakes were ubiquitous (intakes of 13 ± 1 of 27 micronutrients were inadequate) and did not depend on race, status, or access to supermarkets. Younger (40-64 y) lean patients had inadequate intakes of 20 ± 2 micronutrients, which was more than the other weight/age subgroups (all P < .01). Physical activity levels did not differ across weight and age groups. CONCLUSIONS Patients with HF may be at risk of malnutrition due to numerous inadequate micronutrient intakes; younger lean patients may have an especially high risk. Future studies are needed to confirm these preliminary findings and to investigate the possibility that incorporating a micronutrient-dense meal plan will improve patient outcomes.
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Affiliation(s)
- Paulina M Shetty
- Department of Nutrition and Dietetics, Doisy College of Health Sciences of Saint Louis University, St. Louis, Missouri
| | - Paul J Hauptman
- Center for Comprehensive Cardiovascular Care, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Lauren K Landfried
- Department of Nutrition and Dietetics, Doisy College of Health Sciences of Saint Louis University, St. Louis, Missouri
| | - Keval Patel
- Center for Comprehensive Cardiovascular Care, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Edward P Weiss
- Department of Nutrition and Dietetics, Doisy College of Health Sciences of Saint Louis University, St. Louis, Missouri.
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Valko M, Jomova K, Rhodes CJ, Kuča K, Musílek K. Redox- and non-redox-metal-induced formation of free radicals and their role in human disease. Arch Toxicol 2015; 90:1-37. [DOI: 10.1007/s00204-015-1579-5] [Citation(s) in RCA: 535] [Impact Index Per Article: 59.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 08/11/2015] [Indexed: 02/07/2023]
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