Abstract
Heart failure (HF) is a plague of the aging population in industrialized countries that continues to cause many deaths despite intensive research into more effective treatments. Although the therapeutic arsenal to face heart failure has been expanding, the relatively short life expectancy of HF patients is pushing towards novel therapeutic strategies. Heart failure is associated with drastic metabolic disorders, including severe myocardial mitochondrial dysfunction and systemic nutrient deprivation secondary to severe cardiac dysfunction. To date, no effective therapy has been developed to restore the cardiac energy metabolism of the failing myocardium, mainly due to the metabolic complexity and intertwining of the involved processes. Recent years have witnessed a growing scientific interest in natural molecules that play a pivotal role in energy metabolism with promising therapeutic effects against heart failure. Among these molecules, B vitamins are a class of water soluble vitamins that are directly involved in energy metabolism and are of particular interest since they are intimately linked to energy metabolism and HF patients are often B vitamin deficient. This review aims at assessing the value of B vitamin supplementation in the treatment of heart failure.
Highlights
Heart failure (HF), as the outcome of many cardiovascular diseases, is one of the major causes of death in industrialized countries and a substantial economic burden worldwide.According to recent estimations, 1 to 2% of the global adult population could be affected by this syndrome, with a prevalence of approximately 65 million patients worldwide [1].This figure is expected to increase as the population ages, urging the scientific community to expand their therapeutic arsenal to improve the survival rate of HF patients
Beyond the fact that this study showed that a supplementation with folate and cobalamin was beneficial for the heart facing pressure overload, the preservation of energy metabolism described in this work suggests that B vitamins could be part of a metabolic therapy of HF
We have presented ample evidence that B vitamins are important factors involved at all levels of the regulation of cardiac energy metabolism
Summary
Heart failure (HF), as the outcome of many cardiovascular diseases, is one of the major causes of death in industrialized countries and a substantial economic burden worldwide. 1 to 2% of the global adult population could be affected by this syndrome, with a prevalence of approximately 65 million patients worldwide [1] This figure is expected to increase as the population ages, urging the scientific community to expand their therapeutic arsenal to improve the survival rate of HF patients. Standard HF therapies target the dysregulation of the neurohormonal system or reduce the cardiac workload These therapies, neglect the profound alterations of energy metabolism encountered in HF due to the lack of efficient tools for the metabolic treatment of this syndrome. 40–50% lower PCr content than a healthy heart [4,5,6] This incapacity is due to profound perturbations in the regulations and the efficiency of many reactions/processes involved in energy molecule production [7]. We review the use of B vitamins in the preclinical and clinical context of HF while assessing the value of B vitamin supplementation in the treatment of this debilitating syndrome
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