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

• Published in: European journal of heart failure Vol. 3; no. 6; pp. 661 - 669
• Main Authors: de Lorgeril, Michel, Salen, Patricia, Accominotti, Michèle, Cadau, Monique, Steghens, Jean-Paul, Boucher, François, de Leiris, Joël
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-12-2001; Elsevier; European Society of Cardiology (Wiley)
• Subjects: Adult; Aged; Antioxidants; Antioxidants - metabolism; Antioxidants - therapeutic use; Ascorbic Acid; Ascorbic Acid - metabolism; Ascorbic Acid - therapeutic use; beta Carotene; beta Carotene - metabolism; beta Carotene - therapeutic use; Cardiomyopathies; Cardiomyopathies - blood; Cardiomyopathies - complications; Cardiomyopathies - diet therapy; Chronic Disease; Feeding Behavior - physiology; Female; Food and Nutrition; Food Habits; Heart Failure; Heart Failure - blood; Heart Failure - complications; Heart Failure - psychology; Humans; left ventricular ejection fraction; Life Sciences; Male; Middle Aged; nutrition; Oxidative Stress; Oxidative Stress - physiology; peak exercise oxygen consumption; Selenium; Selenium - metabolism; Selenium - therapeutic use; Ventricular Function, Left; Ventricular Function, Left - drug effects; vitamin C; Peak exercise oxygen consumption; Selenium; Nutrition; Left ventricular ejection fraction; Beta-carotene; Vitamin C
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1016/S1388-9842(01)00179-9

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 V
o
2) 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 V
o
2 or LVEF. Dietary intake (P<0.05) and blood levels of selenium (P<0.0005) were lower in CHF. Peak V
o
2 (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.