Abstract
Amino acids play a key role in multiple cellular processes. Amino acids availability is reduced in patients with heart failure (HF) with deleterious consequences on cardiac and whole-body metabolism. Several metabolic abnormalities have been identified in the failing heart, and many of them lead to an increased need of amino acids. Recently, several clinical trials have been conducted to demonstrate the benefits of amino acids supplementation in patients with HF. Although they have shown an improvement of exercise tolerance and, in some cases, of left ventricular function, they have many limitations, namely small sample size, differences in patients’ characteristics and nutritional supplementations, and lack of data regarding outcomes. Moreover recent data suggest that a multi-nutritional approach, including also antioxidants, vitamins, and metals, may be more effective. Larger trials are needed to ascertain safety, efficacy, and impact on prognosis of such an approach in HF.
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Abbreviations
- 6MWD:
-
6-min walking distance
- AAs:
-
Amino acids
- ATP:
-
Adenosine triphosphate
- BID:
-
Twice daily
- BMI:
-
Body mass index
- BW:
-
Body weight
- CAD:
-
Coronary arteries disease
- CHF:
-
Chronic heart failure
- COPD:
-
Chronic obstructive pulmonary disease
- CRP:
-
C-reactive protein
- GH:
-
Growth hormone
- HF:
-
Heart failure
- HFpEF:
-
Heart failure preserved ejection fraction
- IGF-1:
-
Insulin-like growth factor 1
- IL-1:
-
Interleukin 1
- IV:
-
Intravenous
- LVEDD:
-
Left ventricle end-diastolic diameter
- LVEDV:
-
Left ventricle end-diastolic volume
- LVEF:
-
Left ventricle ejection fraction
- LVESV:
-
Left ventricle end-systolic volume
- MET:
-
Metabolic equivalent
- MLWHFQ:
-
Minnesota Living With Heart Failure Questionnaire
- NO:
-
Nitric oxide
- NOS:
-
Nitric oxide synthase
- NYHA:
-
New York Heart Association
- OD:
-
Once daily
- sPAP:
-
Systolic pulmonary artery pressure
- RVEF:
-
Right ventricle ejection fraction
- TID:
-
Three times daily
- TNF-α:
-
Tumor necrosis factor α
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Marco Metra has received honoraria from Abbott Vascular, Amgen, Bayer, Novartis, Servier for participation at advisory board meetings and Committees for ongoing trials.
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Carubelli, V., Castrini, A.I., Lazzarini, V. et al. Amino acids and derivatives, a new treatment of chronic heart failure?. Heart Fail Rev 20, 39–51 (2015). https://doi.org/10.1007/s10741-014-9436-9
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DOI: https://doi.org/10.1007/s10741-014-9436-9