Query: role of micronutrients in heart disease

title: Myocardial energetics and the role of micronutrients in heart failure: a critical review.
abstract: Heart failure is a multifactorial disease with poor prognosis. There are many hypotheses regarding the cause of heart failure. Leading among them are the hemodynamic and the neuro hormonal hypotheses. Although the energy depletion hypothesis has been fairly recent, there is evidence suggesting that declining bioenergy plays a major role in heart failure. This review explored the myocardial energy depletion hypothesis from the role of micronutrients in correcting and alleviating symptoms of heart failure. Even though focus was on key nutrients such as coenzyme Q10, thiamine, riboflavin, L carnitine, and taurine, emphasis was on the combined effect of multiple micronutrients as a whole. Search from databases from 2000 to 2015 produced four clinical studies using multiple micronutrients on heart failure. Evidence from the studies show that using high doses of multiple micronutrients may have positive effects on heart failure and simultaneously support the myocardial energy depletion hypothesis.

title: Role of Micronutrients on Subclinical Atherosclerosis Micronutrients in Subclinical Atherosclerosis.
abstract: Atherosclerotic cardiovascular disease (CVD) leading to coronary heart disease is the leading cause of morbidity and mortality in the world. Nutrition is one of the key factors in the etiology of atherosclerosis. Micronutrient supplements are widely used to prevent many chronic diseases including atherosclerosis. However, scientific evidence regarding this issue is still insufficient and current data on the association of dietary micronutrients and CVD risk is contradictory. Most of the randomized studies have failed to demonstrate beneficial effects of micronutrient supplementation on markers of subclinical atherosclerosis. In this review, role of each micronutrient on subclinical atherosclerosis will be evaluated thoroughly.

title: Dietary Thiols: A Potential Supporting Strategy against Oxidative Stress in Heart Failure and Muscular Damage during Sports Activity
abstract: Moderate exercise combined with proper nutrition are considered protective factors against cardiovascular disease and musculoskeletal disorders. However, physical activity is known not only to have positive effects. In fact, the achievement of a good performance requires a very high oxygen consumption, which leads to the formation of oxygen free radicals, responsible for premature cell aging and diseases such as heart failure and muscle injury. In this scenario, a primary role is played by antioxidants, in particular by natural antioxidants that can be taken through the diet. Natural antioxidants are molecules capable of counteracting oxygen free radicals without causing cellular cytotoxicity. In recent years, therefore, research has conducted numerous studies on the identification of natural micronutrients, in order to prevent or mitigate oxidative stress induced by physical activity by helping to support conventional drug therapies against heart failure and muscle damage. The aim of this review is to have an overview of how controlled physical activity and a diet rich in antioxidants can represent a "natural cure" to prevent imbalances caused by free oxygen radicals in diseases such as heart failure and muscle damage. In particular, we will focus on sulfur containing compounds that have the ability to protect the body from oxidative stress. We will mainly focus on six natural antioxidants: glutathione, taurine, lipoic acid, sulforaphane, garlic and methylsulfonylmethane.

title: Pathophysiology of cardiovascular diseases and role of vitamins, herbal extracts in the reduction of cardiovascular risks.
abstract: Heart disease (cardiovascular disease: CVD) is considered as the leading cause of worldwide death. These diseases are recognized as group of disorders which are related to heart and blood vessels. Generally, heart diseases are considered life style associated diseases but many other factors are also found associated with cardiovascular diseases.  The aim of this review is to provide the till date information regarding local and circulatory disorders, role of different vitamin and herbs on heart diseases.  This review article contains a detailed survey of literature about cardiovascular diseases which was available in different online databases such as; PubMed, Web of Science, Science Direct, Elsevier, and Google Scholar etc. In this review, authors have focused on description of cardiovascular disorders, their pathophysiological properties and importance of micronutrients, vitamins and herbs in management of cardiovascular diseases.  Cardiovascular diseases are considered the responsible approximately for 17.9 million deaths annually at global level. Surprisingly, low and middle income countries counts for 75% of CVD deaths. These diseases represents disorders related circulatory systems specially heart and coronary arteries. Many life style associated factors such as; high cholesterol consumption, smoking, alcohol consumption, tobacco use, metabolic disorders, stress, and other factors such as; family history, age, gender and genetic factors etc have been found involved in establishment of CVDs. That's why management of diet, management of tobacco and alcohol consumption, management of stress, increased physical activities are considered population wide strategies for control cardiovascular diseases. On the basis of pathophysiology, heart diseases are of many types and out of them acute myocardial infarction (AMI) and sudden cardiac death (SCD) are considered serious and catastrophic cardiac disorders. Intake of vitamins, micronutrients, lycopene, omega 3 fatty acid and many herbs like Crataegus oxyacantha (Hawthron) Allium sativum (garlic) Salvia miltiorrhiza (Danshen) Ganoderma lucidum (lingzhi) Ginkgo biloba have been identified good for cardiovascular diseases management and treatment.  Cardiovascular dieseases are considered one of the fatal clinical conditions as many of them are asymptomatic. The regulation of diet, increased physical activities, and health life style are recommened to control development of cardiovascular problems. Including this, scintific studies have supported the role of many vitamins, nutrients and herbs as beneficial in cardiovascular diseases but many of them could not demonstrate their role at clinical level but it is suggested that their role as nutriens can not be ignored and their consumption may reduc the cardiovascular risks.

title: The trace elements in congenital cyanotic heart disease
abstract: The trace elements are essential micronutrients that have important physiological, metabolic, and homeostatic roles in the human being. Up till now the actually role and effect of the trace elements on myocardial metabolism specifically on congenital cyanotic heart disease is not entirely clear.  This study aimed to detect the serum level of selected trace elements (zinc, copper and selenium) and evaluate its effect and relation in congenital cyanotic heart disease.  This study had enrolled upon 50 children, included 30 patients with congenital cyanotic heart disease and 20 age matched normal healthy children as control group. All groups were subjected to thorough clinical history, examination and specific cardiac investigation as well as detection of serum levels of zinc, copper and selenium. All results were statistical analyzed.  The current study revealed that a highly significant decrease in the serum level of both zinc and selenium (p 0.00l and p 0.01) however serum copper level has non significant increase in congenial cyanotic heart disease, were (p 0.95) There was non significant correlation between the mean serum levels of trace elements and the hemodynamic parameters, Also there were non significant correlations between the age and sex of the studied group and the mean serum levels of these trace elements (p 0.05)  Congenital cyanotic heart disease were associated with a highly significant decrease in the mean serum selenium and zinc levels, when compared with control group and non significant increase the mean serum copper levels. Changes in these trace elements suggested to play an important role in the pathogenesis of myocardial damage in congenital cyanotic heart disease.

title: Polyphenols more than an Antioxidant: Role and Scope
abstract: In this article, an attempt has been made review on phenolics antioxidant activity, and characteristics, as well as the constituents of the different phenolics present in various consumable food items, which reduce the risk of non communicable diseases. Some polyphenolic compounds are present in selected species, which are beneficial to public health, and it should be comprised as component of food habits for a proper nutrition's plan. Polyphenols are basically a natural compound and their micronutrients are found in different fruits, beverages, and vegetables. There is no specific deficiency disease caused due to the low dietary intake of phenolics; while the proper intake possibly gives health benefits. Polyphenols are antioxidants, and evidence for their role with improved heart health, neurodegenerative (Alzheimer's disease) diseases, better blood sugar control, diabetes, reduced inflammation, and a reduced risk of cancer development was studied. A comprehensive understanding of the biological availability of the nutritional polyphenols will helpful to recognize those that are beneficial and protective for human health. Based on latest reports, polyphenolic compounds occupy a unique place in environmental science as an important and common class of bioactive natural products globally. It is building a bridge between different interdisciplinary academic fields of science. This work is based on the reports examined the health effect of polyphenols until today.

title: Cardiac involvement in inflammatory bowel disease: role of acylcarnitine esters.
abstract: Cardiovascular complications have been frequently described in Inflammatory Bowel Disease (IBD) Both Crohn disease and Ulcerative Colitis are characterized by malabsorption of some micronutrients, such as carnitine, which is a very important element for myocardial metabolism, being demonstrated that its deficiency correlates with heart involvement in coeliac disease. Aims of this study are to evaluate cardiac function in IBD patients asymptomatic for cardiovascular diseases and to correlate the cardiac data with the profile of carnitine esters plasma levels.  The study was carried out on 20 IBD patients by comparison with 18 sex and age matched clinically healthy controls. Personal and familial history, physical examination, standard electrocardiogram and echocardiogram were performed in all subjects. Complete panel of nutritional status parameters and serum levels of free carnitine and its esters were evaluated both in IBD patients and control subjects.  Isovaleryl carnitine, Tiglyl carnitine, Octenoylcarnitine and Decanoyl carnitine, were found to be significantly lower in IBD patients. Significant correlations were found between some carnitine esters and echocardiographic parameters although total and free carnitine were meanly more elevated in IBD. No statistically significant differences in echocardiographic parameters were found between IBD patients and control subjects.  Deficiency of some isoforms of carnitine, especially those esterified with short chain fatty acids, may play an important role in cardiac involvement in course of IBD and could lead, over time, to dilated cardiomiopathy.

title: Nutrition and Heart Disease: Causation and Prevention
abstract: DIETS AND HEART DISEASE PREVENTION The Role of the Dietitian in reducing cardiovascular risk: an evidence based approach, Hooper Seafood and Myocardial Infarction in China, Yuan The Low Occurrence of Coronary Heart Disease in Sub Saharan African Populations, Walker Dietary Prevention of Coronary Heart Disease, de Lorgeril P.Salen Effects of Nutritional Education on Cardiovasular Risk Factors, Bemelmans NUTRIENTS AND HEART DISEASE Micronutrients and Cardiovascular Disease, Witte, Clark Leptin and Blood Pressure, Swoap, Overton Retinol, Beta Carotene, and alpha tocopherol in Heart Disease, Lopes, Casal, Oliveira, Barros Folate, Homocysteine, and Heart Disease, Ashfield Watt, Burr, McDowell FOODS AND MACRONUTRIENTS IN HEART DISEASE Flavonoids (also known as Bioflavonoids) Extracted and in  Role in Hypertention Prevention and Treatment, Mlakar, Simpson High Carbohydrate Diets and Lipids Metabolism, Beylot Vasculoprotective Effects of Olive Oil: Epidemiological Background and Direct Vascular Antiatherogenic Properties, Massaro, Scoditti Cardiovascular Effects of Dietary Soy, Clarkson. Appt Malnutrition and the Heart: A Pediatric Perspective, Venugopalan Plant Sterols and Plant Stanols, lipoprotein metalbolism, and cardiovascular disease, Naumann, Plat, Mensink Non Nutrient Food Factors and Cardiovascular Diseases, S. Vaghefi AGE AND HEART DISEASE Age Related Cardiac Dysfunction, Yang, Larson, Watson Inducible Nitric Oxide Synthase (iNOS) and Heart Failure, Yang, Larson, Watson

title: Chronic heart failure and micronutrients.
abstract: Heart failure (HF) is associated with weight loss, and cachexia is a well recognized complication. Patients have an increased risk of osteoporosis and lose muscle bulk early in the course of the disease. Basal metabolic rate is increased in HF, but general malnutrition may play a part in the development of cachexia, particularly in an elderly population. There is evidence for a possible role for micronutrient deficiency in HF. Selective deficiency of selenium, calcium and thiamine can directly lead to the HF syndrome. Other nutrients, particularly vitamins C and E and beta carotene, are antioxidants and may have a protective effect on the vasculature. Vitamins B6, B12 and folate all tend to reduce levels of homocysteine, which is associated with increased oxidative stress. Carnitine, co enzyme Q10 and creatine supplementation have resulted in improved exercise capacity in patients with HF in some studies. In this article, we review the relation between micronutrients and HF. Chronic HF is characterized by high mortality and morbidity, and research effort has centered on pharmacological management, with the successful introduction of angiotensin converting enzyme inhibitors and beta adrenergic antagonists into routine practice. There is sufficient evidence to support a large scale trial of dietary micronutrient supplementation in HF.

title: Heart Failure in Epidermolysis Bullosa.
abstract: The term inherited epidermolysis bullosa (EB) describes a group of genetic disorders in which a protein defect causes skin fragility and subsequent blistering. It is a rare disease, with a prevalence of just 8 cases per million population. It can affect deeper layers, and patients may also develop complications in other organs, caused not by the genetic defect itself but by its consequences. One such complication is dilated cardiomyopathy, which needs to be contemplated in patients with EB, not so much because of its frequency (which is low) but because of its severity and the important role of early diagnosis and treatment in prognosis. The pathogenesis of dilated cardiomyopathy in patients with EB is unknown. It has been associated with numerous factors, such as deficiencies in certain micronutrients (iron, thiamine, selenium, carnitine) and iron overload, and it may be multifactorial. Very few case series of dilated