Nutritional and Nutraceutical Support to the Failing Myocardium: A Possible Way of Potentiating the Current Treatment of Heart Failure

Abstract

Heart failure (HF) is a complex condition that affects 1-2% of the global population. The presence of comorbidities like diabetes, hypertension, hyperlipidemia, or obesity has been shown in various studies to elevate mortality and hospitalization rates in HF patients. Insufficient outcomes persist in HF, necessitating additional research to address unmet needs in disease management. Lifestyle modifications, including smoking cessation, decreased alcohol consumption, regular exercise, cardiac rehabilitation, and a balanced diet, can prevent and treat a wide range of HF cases. In this review, we aimed to examine how lifestyle changes, nutrition, and nutraceutical supplements can play a role in preventing heart failure and supporting its treatment. A detailed and comprehensive analysis of the most recent data present in the literature could help identify potential candidates for future clinical trials in HF management. There is a growing body of evidence supporting the importance of closely monitoring nutritional balance, including micronutrients and nutraceuticals, in HF patients for better symptom management and outcomes. Despite promising results from initial approaches, the lack of conclusive evidence from recent studies and meta-analyses questions the widespread use of nutraceutical supplementation in HF patients. Further studies are necessary to determine the most effective way to use nutraceutical supplementation in the treatment of myocardial dysfunction in HF patients.

Keywords: heart failure; lifestyle modifications; nutraceutical supplementation; phytochemical derivatives.

Figure 1

According to HF guidelines, the risk of heart failure can be reduced by minimizing salt consumption, substance abuse, fluid restriction, and weight loss through healthy eating, exercise, alternative exercise, and cardiac rehabilitation.

Figure 2

Coenzyme Q10 (CoQ10) is a fat-soluble cofactor that plays a role in the mitochondrial chain of electronic transport. In biological membranes, including mitochondria, CoQ10 acts as a strong antioxidant by blocking lipid peroxidation and has important anti-inflammatory properties, protecting myocardial tissue. Energy-intensive tissues, such as the heart, skeletal muscle, and neurons, have high concentrations of CoQ10, while aging and oxidative stress lead to a decrease in its concentration. Long-term administration of CoQ10 in addition to standard therapy for chronic HF led to a lowering in hospitalizations for heart failure, episodes of pulmonary edema, and cardiac asthma, reducing cardiovascular death.

Figure 3

Oleuropein-mediated heart benefits obtained from olive leaves and fruits after administration to rats. OL promotes the reduction of creatinine kinase MB (CK-MB) isoenzyme levels and lactate dehydrogenase (LDH) levels, effectively decrease LDL, VLDL cholesterol levels, while increasing HDL cholesterol in vivo. These effects promote the reduction of blood pressure by vasodilation, stabilization of heart rhythm, protection of cardiomyocytes from oxidative stress by lowering the damage caused by free radicals, improvement in mitochondrial function and resistance of cardiomyocytes to ischemic events. Creatine kinase myocardial band (CK-MB); lactate dehydrogenase (LDH); high-density lipoprotein (HDL); low-density lipoprotein (LDL); very-low-density lipoprotein (VLDL).