Dietary and blood antioxidants in patients with chronic heart failure.
Insights into the potential importance of selenium in heart failure.
de Lorgeril M; Salen P; Accominotti M; Cadau M; Steghens JP;
Boucher F; de Leiris J
European Journal of Heart Failure 2001 Dec;3(6):661-9
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 age- and sex-matched controls.
Two indexes of the severity of CHF, peak exercise oxygen consumption (peak
VO2) and left ventricular ejection fraction (LVEF), were measured and
their relations with antioxidants were analysed. RESULTS: Whereas plasma
alpha-tocopherol and retinol were in the normal range, vitamin C (P=0.005)
and beta-carotene (P=0.01) were lower in CHF. However, there was no significant
association between vitamins and either peak VO2 or LVEF. Dietary intake
(P<0.05) and blood levels of selenium (P<0.0005) were lower in CHF.
Peak VO2 (but not LVEF) was strongly correlated with blood selenium: r=0.76
by univariate analysis (polynomial regression) and r=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.