Nutrient dyshomeostasis in congestive heart failure.
The clinical syndrome congestive heart failure (CHF) has its origins rooted in a salt-avid state mediated largely by effector hormones of the renin-angiotensin-aldosterone system. In recent years, this cardiorenal perspective of CHF has taken on a broader perspective. One which focuses on a progressive systemic illness, whose major features include the presence of oxidative stress in diverse tissues and elevated circulating levels of proinflammatory cytokines coupled with a wasting of soft tissues and bone. Experimental studies, which simulate chronic renin-angiotensin-aldosterone system activation, and translational studies in patients with salt avidity having decompensated biventricular failure with hepatic and splanchnic congestion have forged a broader understanding of this illness and the important contribution of a dyshomeostasis of Ca2+, Mg2+, Zn2+, Se2+, and vitamins D, B12, and B1. Herein, we review biomarkers indicative of the nutrient imbalance found in CHF and raise the question of a need for a polynutrient supplement in the overall management of CHF.
Kamalov
German
G
Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Holewinski
Joshua P
JP
Bhattacharya
Syamal K
SK
Ahokas
Robert A
RA
Sun
Yao
Y
Gerling
Ivan C
IC
Weber
Karl T
KT
D001741:Black or African American; D000804:Angiotensin II / Q000378:metabolism; D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D006333:Heart Failure / Q000503:physiopathology*; D006706:Homeostasis; D006801:Humans; D018377:Neurotransmitter Agents / Q000378:metabolism; D009748:Nutrition Disorders / Q000503:physiopathology*; D018384:Oxidative Stress
D000975:Antioxidants; D015415:Biomarkers; D018377:Neurotransmitter Agents; D000804:Angiotensin II