Selenium level in patients with heart failure versus normal individuals

Mirdamadi, Ahmad; Rafiei, Rahmatollah; Kahazaipour, Gharae; Fouladi, Lotfollah

doi:10.4103/ijpvm.ijpvm_45_18

Cited by 18 publications

(10 citation statements)

References 24 publications

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“…Older age, lower levels of albumin, worse kidney function, higher levels of NT-proBNP, and the presence of orthopnea and iron deficiency were established as independent predictors of selenium levels <100 μg/L in patients with worsening HF [ 20 ]. These observations are supported by similar findings in other small cohorts [ 32 – 35 ]. While these studies [ 7 , 32 – 35 ] focused mainly on HF with reduced ejection fraction (HFrEF), one small cohort-study aimed to compare selenium levels between HFrEF and HF with preserved ejection fraction (HFpEF) [ 36 ].…”

Section: Introductionsupporting

confidence: 91%

“…These observations are supported by similar findings in other small cohorts [ 32 – 35 ]. While these studies [ 7 , 32 – 35 ] focused mainly on HF with reduced ejection fraction (HFrEF), one small cohort-study aimed to compare selenium levels between HFrEF and HF with preserved ejection fraction (HFpEF) [ 36 ]. This study [ 36 ] showed that HFrEF patients have significantly lower selenium levels (HFrEF, 73.6 ± 7.5 μg/L) compared to those with HFpEF (77.7 ± 4.9 μg/L), but only selenium levels <90μg/L were reported in this study [ 36 ].…”

Section: Introductionsupporting

confidence: 91%

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Selenium, Selenoproteins, and Heart Failure: Current Knowledge and Future Perspective

Al‐Mubarak

Meer

Bömer

2021

Curr Heart Fail Rep

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Purpose of Review (Mal-)nutrition of micronutrients, like selenium, has great impact on the human heart and improper micronutrient intake was observed in 30–50% of patients with heart failure. Low selenium levels have been reported in Europe and Asia and thought to be causal for Keshan disease. Selenium is an essential micronutrient that is needed for enzymatic activity of the 25 so-called selenoproteins, which have a broad range of activities. In this review, we aim to summarize the current evidence about selenium in heart failure and to provide insights about the potential mechanisms that can be modulated by selenoproteins. Recent Findings Suboptimal selenium levels (<100 μg/L) are prevalent in more than 70% of patients with heart failure and were associated with lower exercise capacity, lower quality of life, and worse prognosis. Small clinical trials assessing selenium supplementation in patients with HF showed improvement of clinical symptoms (NYHA class), left ventricular ejection fraction, and lipid profile, while governmental interventional programs in endemic areas have significantly decreased the incidence of Keshan disease. In addition, several selenoproteins are found impaired in suboptimal selenium conditions, potentially aggravating underlying mechanisms like oxidative stress, inflammation, and thyroid hormone insufficiency. Summary While the current evidence is not sufficient to advocate selenium supplementation in patients with heart failure, there is a clear need for high level evidence to show whether treatment with selenium has a place in the contemporary treatment of patients with HF to improve meaningful clinical endpoints. Graphical abstract

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Section: Introductionsupporting

confidence: 91%

Section: Introductionsupporting

confidence: 91%

Selenium, Selenoproteins, and Heart Failure: Current Knowledge and Future Perspective

Al‐Mubarak

Meer

Bömer

2021

Curr Heart Fail Rep

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“…The important consideration is the possible benefit from Se homeostasis maintenance to improve the high prevalence of malnutrition and poor prognosis in patients with HF 21 . Although the decreased Se level was frequent in patients with HF compared to health controls 12 , 22 , 23 , the definitely correlation between this reduction and long-term survival was not well-established. Recently, an European multinational prospective cohort study revealed a 20.4% of Se deficiency among 2516 worsening HF patients, and found this deficiency in HF patients is independently associated with impaired exercise tolerance and a 50% higher mortality rate 13 .…”

Section: Discussionmentioning

confidence: 91%

The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Zhang

Chang

Zhang

et al. 2021

Sci Rep

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Whether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); Ptrend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

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“…Selenium deficiency may be crucial to maintaining stable hemodynamics in patients with a history of chronic heart failure and ischemic heart disease. Indeed, there have been several reports suggesting that selenium levels affect chronic heart failure or coronary heart disease ( 12 - 14 ). Another study showed the effects of selenium supplementation on reducing NT-proBNP levels and cardiovascular mortality ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Refractory Hypotension Caused by Selenium Deficiency in a Patient on Peritoneal Dialysis

et al. 2021

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Selenium is essential for human health; its deficiency leads to cardiac dysfunction. We herein report a 79year-old man on peritoneal dialysis who presented with refractory hypotension caused by selenium deficiency. He was admitted to our hospital with bacterial pneumonia and hypotension and abnormal electrocardiogram (ECG) findings. Despite improvement of pneumonia, his hypotension continued, and intravenous noradrenalin could not be discontinued. His serum selenium level was extremely low, and he was started on intravenous selenium. His hypotension and ECG findings gradually improved, and noradrenalin was discontinued. Physicians should consider selenium deficiency when patients on PD show refractory hypotension.

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Selenium level in patients with heart failure versus normal individuals

Cited by 18 publications

References 24 publications

Selenium, Selenoproteins, and Heart Failure: Current Knowledge and Future Perspective

Selenium, Selenoproteins, and Heart Failure: Current Knowledge and Future Perspective

The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Refractory Hypotension Caused by Selenium Deficiency in a Patient on Peritoneal Dialysis

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