Micronutrient deficiencies in heart failure: mitochondrial dysfunction as a common pathophysiological mechanism?

Bomer, N., Pavez-Giani, M. G., Grote Beverborg, N., Cleland, J. G.F. , van Veldhuisen, D. J. and van der Meer, P. (2022) Micronutrient deficiencies in heart failure: mitochondrial dysfunction as a common pathophysiological mechanism? Journal of Internal Medicine, 291(6), pp. 713-731. (doi: 10.1111/joim.13456) (PMID:35137472)

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Abstract

Heart failure is a devastating clinical syndrome, but current therapies are unable to abolish the disease burden. New strategies to treat or prevent heart failure are urgently needed. Over the past decades, a clear relationship has been established between poor cardiac performance and metabolic perturbations, including deficits in substrate uptake and utilization, reduction in mitochondrial oxidative phosphorylation and excessive reactive oxygen species production. Together, these perturbations result in progressive depletion of cardiac adenosine triphosphate (ATP) and cardiac energy deprivation. Increasing the delivery of energy substrates (e.g., fatty acids, glucose, ketones) to the mitochondria will be worthless if the mitochondria are unable to turn these energy substrates into fuel. Micronutrients (including coenzyme Q10, zinc, copper, selenium and iron) are required to efficiently convert macronutrients to ATP. However, up to 50% of patients with heart failure are deficient in one or more micronutrients in cross-sectional studies. Micronutrient deficiency has a high impact on mitochondrial energy production and should be considered an additional factor in the heart failure equation, moving our view of the failing myocardium away from an “an engine out of fuel” to “a defective engine on a path to self-destruction.” This summary of evidence suggests that supplementation with micronutrients—preferably as a package rather than singly—might be a potential therapeutic strategy in the treatment of heart failure patients.

Item Type:Articles
Additional Information:NB is supported by a Dutch Research Council (NWO) Open Competition ENW-M grant (OCENW.KLEIN.483). JGFC is supported by a British Heart Foundation (BHF) Centre of Research Excellence Award (RE/18/6/34217). PvdM is supported by a the European Research Council (ERC) Starting Grant (StG 715732).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Bomer, N., Pavez-Giani, M. G., Grote Beverborg, N., Cleland, J. G.F., van Veldhuisen, D. J., and van der Meer, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Journal of Internal Medicine
Publisher:Wiley
ISSN:0954-6820
ISSN (Online):1365-2796
Published Online:09 February 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Journal of Internal Medicine 291(6): 713-731
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science