Long-term multiple micronutrient supplementation significantly reduced LV volumes (-13.1% vs +3.8%; P<0.05) and improved LVEF and quality-of-life in elderly patients with chronic heart failure.
RCT (n=30)
double-blind
randomized
Does high-dose multiple micronutrient supplementation improve left ventricular function and quality-of-life in elderly patients with chronic heart failure?
Long-term multiple micronutrient supplementation may improve left ventricular function and quality of life in elderly patients with heart failure with reduced ejection fraction.
Absolute Event Rate: -13.1% vs 3.8%
p-value: p=<0.05
AIMS: Chronic heart failure (CHF) is a common and leading cause of death in industrialized countries. The potential benefits of micronutrient supplementation in CHF are extensive. Therefore, we examined the influence of long-term multiple micronutrient supplementation on left ventricular (LV) function, levels of pro-inflammatory cytokines, and quality-of-life (QoL) in elderly patients with CHF. METHODS AND RESULTS: Thirty CHF patients age 75.4 (0.7), mean (SEM), LV ejection fraction (LVEF) < or =35% were randomized to receive capsules containing a combination of high-dose micronutrients (calcium, magnesium, zinc, copper, selenium, vitamin A, thiamine, riboflavin, vitamin B(6), folate, vitamin B(12), vitamin C, vitamin E, vitamin D, and Coenzyme Q10) or placebo for 9 months in a double-blind fashion. All subjects were on stable optimal medical therapy for at least 3 months before enrolment. At randomization and at study end, tumour necrosis factor-alpha and its soluble receptors TNFR-1 and TNFR-2 were measured and six-minute walk test and QoL were assessed. Cardiac magnetic resonance scanning was performed to evaluate cardiac dimensions and LVEF. Two patients died during follow-up. The remaining patients (14 randomized to placebo and 14 to micronutrients) were well matched for LV function, symptoms, and exercise capacity. At the end of the follow-up period, LV volumes were reduced in the intervention group with no change in the placebo group -13.1 (17.1)% vs. +3.8 (10.0)%; P<0.05. LVEF increased by 5.3+/-1.4% in the intervention group and was unchanged in the placebo group (P<0.05). Patients taking micronutrients also had a significant improvement in QoL score between enrolment and study end +9.5 (1.6)%; P<0.05, whereas those taking placebo had a slight deterioration -1.1 (0.8)%; P=0.12. Six-minute walk test and inflammatory cytokine levels remained unchanged in both groups. CONCLUSION: Long-term multiple micronutrient supplementation can improve LV volumes and LVEF and QoL scores in elderly patients with heart failure due to LV systolic dysfunction.
Witte et al. (Thu,) conducted a rct in chronic heart failure (n=30). multiple micronutrient supplementation vs. placebo was evaluated on Change in left ventricular (LV) volumes (p=<0.05). Long-term multiple micronutrient supplementation significantly reduced LV volumes (-13.1% vs +3.8%; P<0.05) and improved LVEF and quality-of-life in elderly patients with chronic heart failure.