A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure.
BACKGROUND
Oxidative stress is increased in patients with congestive heart failure and can contribute to the progressive deterioration observed in these patients. Increased oxidative stress is the result of either an increased production of free radicals or a depletion of endogenous antioxidants, such as vitamin E.


OBJECTIVE
We aimed to determine whether vitamin E supplementation of patients with advanced heart failure would modify levels of oxidative stress, thereby preventing or delaying the deterioration associated with free radical injury.


METHODS
Fifty-six outpatients with advanced heart failure (New York Heart Association functional class III or IV) were enrolled in a double-blind randomized controlled trial for 12 wk. At a baseline visit and at 2 follow-up visits, blood and breath samples were collected for the measurement of indexes of heart function and disease state, including malondialdehyde, isoprostanes, and breath pentane and ethane. Quality of life was also assessed at baseline and after 12 wk of treatment.


RESULTS
Vitamin E treatment significantly increased plasma concentrations of alpha-tocopherol in the treatment group but failed to significantly affect any other marker of oxidative stress or quality of life. In addition, concentrations of atrial natriuretic peptide (a humoral marker of ventricular dysfunction), neurohormonal-cytokine markers of prognosis, tumor necrosis factor, epinephrine, and norepinephrine were unchanged with treatment and were not significantly different from those in the control group.


CONCLUSIONS
Supplementation with vitamin E did not result in any significant improvements in prognostic or functional indexes of heart failure or in the quality of life of patients with advanced heart failure.
Keith
M E
ME
Toronto Hospital, Ontario, Canada.
Jeejeebhoy
K N
KN
Langer
A
A
Kurian
R
R
Barr
A
A
O'Kelly
B
B
Sole
M J
MJ
D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001944:Breath Tests; D019587:Dietary Supplements; D004311:Double-Blind Method; D004980:Ethane / Q000032:analysis; D005260:Female; D005609:Free Radicals / Q000378:metabolism; D006333:Heart Failure / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood / Q000378:metabolism; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology*; D010420:Pentanes / Q000032:analysis; D011379:Prognosis; D011788:Quality of Life; D012907:Smoking; D017211:Treatment Failure; D014810:Vitamin E / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
D000975:Antioxidants; D005609:Free Radicals; D010420:Pentanes; D014810:Vitamin E; D008315:Malondialdehyde; D004980:Ethane