The Role of B Vitamins in the Management of Heart Failure

Abstract

Heart failure (HF) is the leading cause of morbidity and mortality in industrialized countries, creating a significant burden on both the healthcare system and quality of life. Research efforts continue to explore new pharmaceutical or surgically based approaches to HF management, but the role of nutrition as an adjunct therapy has been largely ignored. Elderly age, anorexia, malabsorption, premature satiety, and disease severity are among the factors identified as contributing to reduced nutrient intakes in patients with HF. These factors suggest that patients with HF are at increased risk of multiple-nutrient deficiencies, including B vitamins. B vitamins may be of particular therapeutic interest because of their key roles as cofactors in energy-producing pathways. Recently, impaired stores of high-energy compounds have been linked with myocardial dysfunction and prognosis in patients with HF. Therefore, deficiencies of B vitamins might contribute to reduced energy stores and disease progression. This review summarizes the existing literature both with respect to the prevalence of B vitamin deficiency as well as evidence from supplementation trials in patients with HF. The findings suggest that most of the literature in this area has focused on thiamin deficiency in patients with HF, whereas other B vitamins remain largely unstudied. Although few sporadic trials suggest a role for B vitamins in the management of HF, none are conclusive. Therefore, there is a need for larger, more robust trials to assist in defining the B vitamin requirements as well as the impact of supplementation on both morbidity and mortality in patients with HF.

The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis

“…Evidence that TD may cause heart failure has been demonstrated [12,19,20], whereby an increase in oxidative stress due to TD led to the apoptosis of cardiomyocytes [21] and produced cardiac remodeling [20,22]. Structural remodeling and the destruction of cardiomyocyte mitochondria were also observed with TD [20].…”

Methoxistasis: Integrating the Roles of Homocysteine and Folic Acid in Cardiovascular Pathobiology

“…Nutritional intake of folate and of the sulfur-containing amino acids methionine and cysteine also affects various enzymatic reactions of the methionine-homocysteine cycle and associated one-carbon metabolism, and, thereby, redox-methylation balance [11,12]. Among cardiovascular diseases, heart failure is likely to be more influenced by changes in redox methylation balance since deficient nutritional intake, catabolic state, and loss of micronutrients due to therapy are all prevalent in patients with heart failure [13]. …”

Thiamine Deficiency (Beriberi) Induced Polyneuropathy and Cardiomyopathy: Case Report and Review of the Literature

“…CHF is a major public concern in the United States. Research has shown that patients with heart failure are at higher risk of developing multiple-nutrient deficiencies including B vitamins [17]. In elderly patients with heart failure, loop diuretics to manage fluid and sodium levels can cause hyper-excretion of thiamine [18], thereby increasing the risk of developing thiamine deficiency.…”