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Vitamins in Heart Failure: Friend or Enemy?
Curr Pharm Des. 2017; 23(25):3731-3742.CP

Abstract

BACKGROUND

The failing heart is characterized by a depleted metabolic energy reserve and the upregulation of several molecular mechanisms leading to cardiac hypertrophy, inflammation, fibrosis, angiogenesis, and apoptosis. Dietary or non-dietary supplementation of vitamins could potentially benefit energy balance.

OBJECTIVE

The objective of the present study was to evaluate all available information on vitamins supplementation in patients with chronic HF for possible beneficial effect on metabolic, inotropic, chronotropic and hemodynamic indices.

METHOD

We searched MEDLINE via Pubmed by using the following terms: "chronic heart failure" OR "cardiomyopathy" AND "vitamins", "vitamin A", "B complex vitamins", "vitamin C", "ascorbic acid", "vitamin D", "retinol", "vitamin E", "thiamine", "riboflavin", "niacin", "pyridoxine", "cobalamin", "folate", "pantothenic acid", "biotin", "tocopherol" and combinations of them.

RESULTS

Data regarding supplementation of micronutrients in HF for most vitamins were sparse, and the inference about cardiovascular outcomes was obscured by the heterogeneity of studies, high inherent morbidity, and mortality of this group of high-risk patients, limited sample sizes in certain studies, unclear design and lack of head to head comparisons. Most vitamins in human trials failed to offer survival, or robust beneficial effect. Mostly indirect favorable evidence is derived from patients with deficiencies of certain micronutrients rather than their ad hoc supplementation.

CONCLUSION

While vitamins and micronutrients are promising compounds for optimizing myocardial metabolism and homeostasis in HF, additional randomized clinical trials of larger scale are warranted to demonstrate the benefits of their supplementation in this high risk group of patients.

Authors+Show Affiliations

First Department of Cardiology, 'Hippokration' Hospital, 114, Vas.Sofias Street, PC 11528, Athens. Greece.First Department of Cardiology, 'Hippokration' Hospital, 114, Vas.Sofias Street, PC 11528, Athens. Greece.First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens. Greece.First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens. Greece.First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens. Greece.Department of Internal Medicine, University Hospital Zurich, Zurich. Switzerland.Laboratory Medicine, Cliniques Universitaires Saint Luc, Brussels Area. Belgium.First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens. Greece.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28325140

Citation

Georgiopoulos, George, et al. "Vitamins in Heart Failure: Friend or Enemy?" Current Pharmaceutical Design, vol. 23, no. 25, 2017, pp. 3731-3742.
Georgiopoulos G, Chrysohoou C, Vogiatzi G, et al. Vitamins in Heart Failure: Friend or Enemy? Curr Pharm Des. 2017;23(25):3731-3742.
Georgiopoulos, G., Chrysohoou, C., Vogiatzi, G., Magkas, N., Bournelis, I., Bampali, S., Gruson, D., & Tousoulis, D. (2017). Vitamins in Heart Failure: Friend or Enemy? Current Pharmaceutical Design, 23(25), 3731-3742. https://doi.org/10.2174/1381612823666170321094711
Georgiopoulos G, et al. Vitamins in Heart Failure: Friend or Enemy. Curr Pharm Des. 2017;23(25):3731-3742. PubMed PMID: 28325140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamins in Heart Failure: Friend or Enemy? AU - Georgiopoulos,George, AU - Chrysohoou,Christina, AU - Vogiatzi,Georgia, AU - Magkas,Nikolaos, AU - Bournelis,Ippokratis, AU - Bampali,Sofia, AU - Gruson,Damien, AU - Tousoulis,Dimitris, PY - 2017/01/03/received PY - 2017/02/19/revised PY - 2017/03/15/accepted PY - 2017/3/23/pubmed PY - 2018/6/5/medline PY - 2017/3/23/entrez KW - Vitamin KW - cardiomyopathy KW - chronic heart failure KW - diet; anti-oxidants KW - metabolism KW - micronutrients SP - 3731 EP - 3742 JF - Current pharmaceutical design JO - Curr. Pharm. Des. VL - 23 IS - 25 N2 - BACKGROUND: The failing heart is characterized by a depleted metabolic energy reserve and the upregulation of several molecular mechanisms leading to cardiac hypertrophy, inflammation, fibrosis, angiogenesis, and apoptosis. Dietary or non-dietary supplementation of vitamins could potentially benefit energy balance. OBJECTIVE: The objective of the present study was to evaluate all available information on vitamins supplementation in patients with chronic HF for possible beneficial effect on metabolic, inotropic, chronotropic and hemodynamic indices. METHOD: We searched MEDLINE via Pubmed by using the following terms: "chronic heart failure" OR "cardiomyopathy" AND "vitamins", "vitamin A", "B complex vitamins", "vitamin C", "ascorbic acid", "vitamin D", "retinol", "vitamin E", "thiamine", "riboflavin", "niacin", "pyridoxine", "cobalamin", "folate", "pantothenic acid", "biotin", "tocopherol" and combinations of them. RESULTS: Data regarding supplementation of micronutrients in HF for most vitamins were sparse, and the inference about cardiovascular outcomes was obscured by the heterogeneity of studies, high inherent morbidity, and mortality of this group of high-risk patients, limited sample sizes in certain studies, unclear design and lack of head to head comparisons. Most vitamins in human trials failed to offer survival, or robust beneficial effect. Mostly indirect favorable evidence is derived from patients with deficiencies of certain micronutrients rather than their ad hoc supplementation. CONCLUSION: While vitamins and micronutrients are promising compounds for optimizing myocardial metabolism and homeostasis in HF, additional randomized clinical trials of larger scale are warranted to demonstrate the benefits of their supplementation in this high risk group of patients. SN - 1873-4286 UR - https://www.unboundmedicine.com/medline/citation/28325140/Vitamins_in_Heart_Failure:_Friend_or_Enemy L2 - http://www.eurekaselect.com/151041/article DB - PRIME DP - Unbound Medicine ER -