• German Kamalov, Joshua P Holewinski, Syamal K Bhattacharya, Robert A Ahokas, Yao Sun, Ivan C Gerling, and Karl T Weber.
• Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
• Am. J. Med. Sci. 2009 Jul 1; 338 (1): 283328-33.

AbstractThe clinical syndrome congestive heart failure (CHF) has its origins rooted in a salt-avid state mediated largely by effector hormones of the renin-angiotensin-aldosterone system. In recent years, this cardiorenal perspective of CHF has taken on a broader perspective. One which focuses on a progressive systemic illness, whose major features include the presence of oxidative stress in diverse tissues and elevated circulating levels of proinflammatory cytokines coupled with a wasting of soft tissues and bone. Experimental studies, which simulate chronic renin-angiotensin-aldosterone system activation, and translational studies in patients with salt avidity having decompensated biventricular failure with hepatic and splanchnic congestion have forged a broader understanding of this illness and the important contribution of a dyshomeostasis of Ca2+, Mg2+, Zn2+, Se2+, and vitamins D, B12, and B1. Herein, we review biomarkers indicative of the nutrient imbalance found in CHF and raise the question of a need for a polynutrient supplement in the overall management of CHF.

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