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Wednesday, September 9, 2015

Comprehensive (especially nutritional) rehabilitation in chronic heart failure

Gąsiorowski A1, Dutkiewicz J.

Heart failure treatment based only on pharmaceutical (conventional) practices further deteriorates the health problem, as in many cases heart failure is caused by a chronic shortage of vitamins and other nutrients in cardiac muscle cells, while diuretic drugs are oriented towards symptoms, not causes. This shortage leads to the weakening of heart functioning as a pump, which results in deterioration of organ blood supply, low arterial pressure and no coverage of current metabolic needs of the organism. Kidney functions, which depend on optimal blood pressure, are impaired, water in the tissues stops and, if diuretics are supplied, water soluble vitamins such as C and B, minerals and microelements are removed from the organism.

According to von Haehling et al. [61], dietary deficiencies in micronutrients and macronutrients contribute to the progression of chronic heart failure from stable disease to devastating cardiac cachexia. The evidence suggests that multiple micronutrient supplementation is potentially beneficial for cachectic patients, and should contain antioxidant supplements and B-group vitamins. Heart failure treatment without refuelling cell nutrients is a noncomprehensive treatment [62].

With a long-term shortage of vitamins the recovery process in vascular walls is excessive. The basic elements for the recession of atherosclerosis are lysine and proline, which comprise collagen, and vitamin C. They are decisive factors in optimal regeneration of the connective tissue of vascular walls. With optimal volumes of nutrients, the cells of the smooth muscles of the vascular wall produce a sufficient amount of activity collagen, guaranteeing wall stability. Vitamins C and E prevent excessive growth of muscle cells [62].

According to Janson [63], taking several supplements that have documented roles in medical therapy, including vitamins C and E, coenzyme Q10, alpha-lipoic acid, chromium, L-carnitine, and quercetin, has beneficiary effect on many diseases, including congestive heart failure.

Aberrations in minerals and micronutrient homeostasis that includes Ca2+, Mg2+, vitamin D, zinc and selenium deficit, appear to be an integral component of pathophysiologic expressions of congestive heart failure and predispose patients to secondary hyperparathyroidism which accounts for bone resorption and contributes to a fall in bone strength that can lead to nontraumatic fractures. Thus, patients with CHF need daily nutrient supplement in addition to their
habitual diet [64].

The deposits in blood vessels are mainly caused by lipoprotein which sticks to collagen molecules in arterial walls. The therapeutic goal of preventing the forming of fat deposits in vascular walls is neutralisation of Lp(a) molecule viscosity, and preventing its attaching to the inner structures of vascular walls. Amino-acids – lysine and proline – form a protective layer around Lp(a) molecules, which prevents the depositing of fat molecules in the vascular wall. They release Lp(a) attached to the vascular wall, which are transported to the liver, where they undergo natural metabolic conversion. This process improves circulation [65, 66, 67, 68].

An additional mechanism influencing the development of atherosclerosis, brain stroke or heart attack, is biological oxidation. Free radicals destroy the tissue of vascular walls, contributing to the depositing of atherosclerotic plaques. Vitamins C and E, beta-carotene, among others, are the strongest antioxidants which protect the cardiovascular system against damage [65, 66, 67, 69, 70, 71, 72].

Modern cell medicine presents a new view concerning the cause of secondary risk factors for the blood system and defines methods of heart disease prevention. Cholesterol, triglycerides, low density lipoproteins (LDL), Lp(a) are repair factors and their level increases in a response to structural weakening of vascular walls. Chronic shortage of vitamins and other nutrients leads to overproduction of repair molecules and deposits of atherosclerotic plaques. The most
significant way of reducing the level of cholesterol and other secondary risk factors in the blood system is stabilisation of vascular walls and, in consequence, reduction of the metabolic demand for increased production of those factors in the liver [73, 74, 75, 76].

The best natural sources for reducing risk factors in the blood are, e.g. vitamin C, B3 (nicotinic acid), B5 (pantothenate), vitamin E, carnitine, coenzyme Q10, vitamin B1, which provide better stability of the vessels’ connective tissue and reduction of demand for repair molecules.

Coenzyme Q10 (ubiquinone, or coQ10) is the most important element in the respiratory pathway, particularly in the heart muscle. It participates in ATP synthesis and is responsible for cell metabolism. It additionally acts as an antioxidant. Up to the age of 30, the human organism produces this coenzyme, after which the production decreases reaching only 50% at the age of 70. Coenzyme Q10 improves heart capacity and corrects energy flow in mitochondria, the majority of which can be found in heart muscles. CoQ10 is essential for the heart muscle, and it helps lower blood pressure, improve congestive heart failure, and protect the brain in degenerative conditions such as Parkinson’s and Alzheimer’s diseases. It also reduces the chance of blood platelets sticking together and obstructing the vessels, thus reducing the chance of heart attacks. It improves immunity, physical capacity, reduces the process of ageing, strengthens the immunity system; it is also used in the case of diabetes and obesity [63, 66, 70, 71, 77].

Scientific and clinical research has confirmed the special importance of carnitine, coenzyme Q10 and other nutrients vital for the improvement of heart muscle work and increasing its contraction. Carnitine optimises fatty acid metabolism and reduces triglyceride level. L-carnitine is essential for the transport of free fatty acids across the mitochondrial membrane, where they are metabolized to create energy.

Low L-carnitine levels reduce the functional capacity of the myocardium, leading to increases in angina and congestive heart failure [63, 78, 79, 80, 81, 82, 83]. In the event of heart failure, vitamin C should be administered; it provides energy for cell metabolism and supports the activity of group B vitamins, which are carriers of cell metabolism bioenergy, concerning in particular heart muscle cells, improving heart beat. This is further enhanced by the production of prostacyclin in arterial walls, tissue hormone inhibiting blood platelets sticking together and expanding blood vessels, especially the coronary vessels, and ensuring the protection and natural healing of vascular walls and normalising increased production of cholesterol and other risk factors in the liver, and their level in blood.


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