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Expert Pearls

Heart Failure - Arginine

Arginine 15-20 gm/d (approximate dosage). [Amino Acids, 2000;18:199-206. 35909 (2000)] Summary

Heart Failure - atherosclerosis, statin - 51028

Statins - The epidemic of atherosclerosis and heart failure may be exacerbated by the widespread use of statins to lower cholesterol by inhibiting vitamin K2 synthesis which effects coronary calcification and testosterone production which is cardioprotective; decreasing selenoprotein production reduces antioxidant enzymes thereby increasing peroxidative damage to heart tissue; inhibiting coenzyme Q10 production thereby acting as a mitochondrial toxin which reduces energy production in heart tissue; and inhibits Heme A biosynthesis which also effects electron transport and energy production. [Expert Rev Clin Pharmacol. 2015 Mar;8(2):189-99. 51028 (10/2015)] Interview PubMed

Heart Failure - Beta-carotene

Beta-carotene 50 mg/d. [Internat J Cardiol, 1996;57:119-127. 26369 (1997)] Summary Interview

Heart Failure - Carnitine

Carnitine (L-) 3 gm/d. [Cardiovas Drugs Ther, 1999;13:537-546. 35944 (1999)] Summary Interview

Heart Failure - Carnitine - 2

Carnitine (L-) 2250 mg/d combined with ubiquinol 270 mg/d divided into 3 capsules t.i.d. after meals and with fatty foods. [Acta Cardiol, 2007; 62(4): 349-54. 45731 (12/2007)] Summary Interview

Heart Failure - Coenzyme Q10

Coenzyme Q10 (myocyte energy production) 100 mg t.i.d.. [Heart Lung Circ, 2003;12(Suppl):S55-S62. 42239 (3/2006)] Summary Interview

Heart failure - Coenzyme Q10 - 2

Coenzyme Q10 50 mg b.i.d.-t.i.d.. [J Card Fail 2006 Aug;12(6):464-72. 44565/ 45278 (12/2006)] Summary Interview

Heart failure - Coenzyme Q10 - 3

Coenzyme Q10 100-300 mg/d (average 240 mg/d) with meals in split doses. 300-600 mg per day may be used to keep CoQ10 levels 3.5 ug/ml or above. [BioFactors, 2005; 25(1-4): 147-152. 44581 (6/2007)] Summary Interview

Heart failure - Coenzyme Q10 - 4

Coenzyme Q10 100 mg/d, hawthorn 150 mg t.i.d. and magnesium chelate 150 mg/d. [Explore (NY), 2006; 2(4): 339-41. 45246 (8/2007)] Summary Interview

Heart Failure - coenzyme q10 - ubiquinol - 47878

Coenzyme Q10 450 - 900 mg/d (ubiquinol) in divided doses with meals. [Biofactors, 2008;32(1-4:119-28. 47878 (9/2011)] Summary Interview PubMed

Heart failure - Exercise training

Exercise training - two phases: 1) exercise 3 x week for 8 weeks at 60% of the peak oxygen uptake; 2) 12-month maintenance program of the same intensity but with only two sessions a week. Each session is 1 hour, beginning with a warm-up phase of stretching exercises followed by 40 minutes of cycling on a stationary cycle ergometer. [Circulation, 1999;99:1173-1182. 31836 (1999)] Summary Interview

Heart failure - Fish Oil

Fish Oil 1-8 gm/d (EPA + DHA); EPA 1.8 gm/d + DHA 1.2 gm/d (improves endothelial function). [Eur J Cardiovasc Prev Rehabil, 2004 Aug;11(4): 267-74. 42230/44924 (9/2006)] Summary Interview

Heart failure - Hawthorn extract

Hawthorn extract 180 to 900 mg/d in devided doses with meals for 4 to 12 weeks provides probable benefit via an inotropic effect (standardized extracts are best such as WS1442 from Schwabe, Germany) [Cochrane Database of Systematic Reviews, 2008; Issue 1, Art. No.: CD005312. DOI: 10.1002/14651858.CD005312.pub2. 45999 (4/2008)] Summary Interview

Heart failure - Hawthorn extract - 2

Hawthorn extract (Special Extract WS 1442) 450 mg (dry extract) b.i.d.. [Forsch Komplementarmed Klass Naturheilkd. 2004 Aug;11 Suppl 1:36-9. 43692 (10/2005)] Summary Interview

Heart Failure - magnesium - 47104

Magnesium citrate at 300 mg/d P.O. [Nutr Metab Cardiovasc Dis, 2009 Feb 6; [Epub ahead of print]. 47104 (6/2009)] Summary Interview PubMed

Heart failure - Magnesium citrate

Magnesium citrate 300 mg/d in single or divided dose with or away from meals lowered CRP in congestive heart failure patients. [Eur J Nutr, 2007 May 3; [Epub ahead of print]. 45307 (7/2007)] Summary Interview

Heart failure - Micronutrient supplement

Micronutrient supplement 4/d (total: calcium 250 mg, magnesium 150 mg, zinc 15 mg, copper 1.2 mg, selenium 50 ug, vitamin A 800 ug, vitamin B1 200 mg, riboflavin 2 mg, vitamin B6 200 mg, folic acid 5 mg, vitamin B12 200 ug, vitamin C 500 mg, vitamin E 400 mg, vitamin D 10 ug and coenzyme Q10 150 mg per day). [Eur Heart J, 2005 Nov;26(21):2238-44. Epub 2005 Aug 4. 43599, 43658/44884 (5/2006)] Summary Interview

Heart failure - Micronutrients

Micronutrients (review of propionyl-L-carnitine, coenzyme Q10, nicotinamide, riboflavin and pantothenic acid, taurine, arginine, antioxidants, copper, selenium, omega-3 fatty acids, testosterone, exercise, fruit and vegetables). [Heart Fail Rev, 2006 Mar;11(1):65-74. 43599, 43658/45188 (9/2006)] Summary Interview

Heart failure - Selenium

Selenium 100 mcg/d. [Heart Fail Rev, 2006 Mar;11(1):13-7. 43599/45183 (11/2006)] Summary Interview

Heart failure - Testosterone

Testosterone 5mg/d transdermal patch. [Eur Heart J, 2006; 27(1): 57-64. 44051/44567 (4/2006)] Summary Interview

Heart Failure - vitamin b1 - 30309

Thiamine (vitamin B1) at 10-20 mg/d as a prophylactic preventive dose in heart failure. Supplementation for different types of deficiency conditions range 5 mg/d to 200 mg three times per day. Loop diuretics can lead to thiamine deficiency and increase risk to heart failure. Carnitine, CoQ10, magnesium orotate, selenium and fish oil have shown some benefit in heart failure. Excess salt restriction, ≤ 1.8 grams per day, may increase the risk to heart failure compared to normal intakes of 2.8 grams per day. Thiamine supplementation is safe and patients with heart failure may improve cardiac function, urine output, weight loss, and signs and symptoms of heart failure. [Congest Heart Fail, 2013 Jul-Aug;19(4):214-22. 30309 (3/2014)] Interview PubMed

Heart failure - Vitamin C

Vitamin C 2 mg/d improved endothelial function. [Circulation, 1998;97:363-368. 29230/29224 (1998)] Summary Interview

Heart failure - Vitamin C - 2

Vitamin C 250 mg/d. [Internat J Cardiol, 1996;57:119-127. 26369 (1997)] Summary Interview

Heart failure - Vitamin D

Vitamin D is low in heart failure. Patients should be assessed for 25 hydroxyvitamin D. [J Clin Endocrinol Metab, 2008 August 5; [Epub ahead of print]. 46572 (9/2008)] Summary Interview

Heart failure - Vitamin D - 2

Vitamin D is low in heart failure. Patients should be assessed for 25 hydroxyvitamin D. [Am Coll Cardiol, 2003;41(1):105-112. 40230 (2003)] Summary Interview

Heart failure - Vitamin E

Vitamin E 400 mg/d (reduced oxidative stress). [Internat J Cardiol, 1996;57: 119-127. 26369 (1997)] Summary Interview
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