Editorial Nutritional Modulators in Chronic Heart Failure

Abstract

Chronic Heart failure (HF) may be associated with cardiac cachexia characterized with weight loss as well as with nutritional deficiency [1-4]. The increased oxidative stress in chronic HF attempts to consume various nutrients present in the cardiomyocyte as well as endogenous antioxidants. Vitamin C, E and beta carotene, as well as coenzyme Q10 are potential antioxidants for protection against oxidative stress developed in HF patients [1-5]. The increase in homocysteine due to oxidative stress, is antagonized by vitamins; B6, B12 and folic acid. The decrease in magnesium and potassium due to long term diuretic therapy in HF which can predispose arrhythmiogenesis, leading to rhythm disturbances and sudden cardiac death [3-5]. L-carnitine, cysteins and taurine amino acids are also reduced in chronic HF and their supplementation may be protective [6-8]. It seems that these nutrients can be administered as nutraceuticals among these patients with chronic HF. Apart from above micronutrients, calcium, selenium, zinc, thiamine, vitamin D and omega-3 fatty acids may play a more important role than previously thought [1-9]. Increased concentration of aldosterone and chronic use of loop diuretics increase urinary excretion of calcium and magnesium, leading to arrhythmias and secondary hyperparathyroidism, which in turn depletes calcium from bone and drives calcium into cells, causing further increase in oxidative stress [8-12]. Vitamin D deficiency, can enhance the damage, which now appears ubiquitous in northern