ischemic heart disease (iHD) is the leading cause of death and chronic disability in the world. iHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/eʹ), were correlated with differential regulation of various metals in patients sera samples (n = 62) using inductive coupled plasma-mass spectrometry (ICP-MS). Chromium, nickel and selenium were found significant (p < 0.05) in patients having EF < 45% compared with EF > 45%. In patients with systolic dysfunction (EF < 45%), the level of selenium was decreased while the level of chromium and nickel was increased compared to patients with EF > 45%. Selenium level was also decreased significantly (p < 0.05) in grade 1A and 2 patients that are considered as higher grades of diastole dysfunction in comparison to grade 0-1. Overall, selenium deficiency was identified in both systolic and diastolic dysfunctions of IHD patients corresponding to the progression of disease that could be related to many metabolic and translational pathways specifically which involve selenoproteins. Cardiovascular diseases (CVDs) are the leading cause of death worldwide 1. An estimated 17.9 million people died from CVDs in 2015, representing 31% of all global deaths. Ischemic heart disease (IHD) account for the majority of the cases of health lost to CVDs. There are large number of prevalent cases of IHD making it the leading cause of chronic disability 1,2. The most common cause of IHD is atherosclerosis which is a chronic inflammatory process represented by highly specific cellular and molecular responses 3. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart 4. Despite advances in the current treatment plans, heart failure remains one of the major health care issues of the world not only due to its increasing prevalence but also health care costs 5 .
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