Dietary and blood antioxidants in patients with chronic heart failure. Insights into the potential importance of selenium in heart failure

Abstract

Ž. Background: Chronic heart failure CHF seems to be associated with increased oxidative stress. However, the hypothesis that antioxidant nutrients may contribute to the clinical severity of the disease has never been investigated. Aims: To examine whether antioxidant nutrients influence the exercise capacity and left ventricular function in patients with CHF. Methods: Dietary intake and blood levels of major antioxidant nutrients were evaluated in 21 consecutive CHF patients and in healthy Ž . age-and sex-matched controls. Two indexes of the severity of CHF, peak exercise oxygen consumption peak VO and left 2 Ž . ventricular ejection fraction LVEF , were measured and their relations with antioxidants were analysed. Results: Whereas Ž . Ž . plasma alpha-tocopherol and retinol were in the normal range, vitamin C Ps 0.005 and beta-carotene Ps 0.01 were lower in CHF. However, there was no significant association between vitamins and either peak VO or LVEF. Dietary intake 2 Ž . Ž . Ž . P -0.05 and blood levels of selenium P-0.0005 were lower in CHF. Peak VO but not LVEF was strongly correlated 2 Ž . Ž . with blood selenium: r s 0.76 by univariate analysis polynomial regression and r s 0.87 P -0.0005 after adjustment for age, sex and LVEF. Conclusions: Antioxidant defences are altered in patients with CHF. Selenium may play a role in the clinical severity of the disease, rather than in the degree of left ventricular dysfunction. Further studies are warranted to confirm the data in a large sample size and to investigate the mechanisms by which selenium and other antioxidant nutrients are involved in CHF. ᮊ

Plasma Vitamin C, but Not Vitamin E, Is Associated With Reduced Risk of Heart Failure in Older Men

“…5 In contrast to the extensive research on vitamins C and E and risk of coronary heart disease (CHD) and cardiovascular disease (CVD), 6,7 less is known about the associations between antioxidant levels and intakes and risks of HF in the general population. Although a number of studies have investigated the role of antioxidants in patients with HF, 8,9 studies on the association between vitamin C and E and the development of HF risk in the general population are limited, and the few trials of antioxidant supplementation in HF have been disappointing. Although 2 studies reported no association between vitamin E supplements and HF in a primary prevention population, 6,10 2 secondary trial studies reported increased risk of HF with vitamin E supplements in those with CVD, 11,12 raising concern about the use of vitamin E supplements.…”

Selenium supplementation does not improve vascular responsiveness in healthy North American men

“…Additional Se intake beyond the nutritional requirement may not increase the activities of these selenoenzymes and thus may confer no additional benefit. The epidemiological evidence is consistent with a saturation effect of Se on cardiovascular health (19), in which Se status predicts cardiovascular disease risk in populations with lower Se status but is not associated with risk in populations with higher Se status (3).…”

Correlation between Keton Body Level in Selenium-Deficient Rats and Oxidative Damages

“…There are number of reports describing heart failure in Se deficiency. 25,26) The visible symptoms of SeD rats, such as hair loss, ateliosis, aggressiveness, etc., however, vary considerably with the feeding conditions and sometimes they can be difficult to distinguish compared with normal animals, especially in older rats. Those symptoms are not peculiar for Se-deficiency and are also observed in several experimental models for nutritional deficiency.…”