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Congestive Heart Failure Chf

Congestive Heart Failure (CHF) Introduction

:chf_20small.jpg Congestive heart failure (CHF) occurs when the heart is unable to effectively pump enough blood throughout the body. When the pumping ability of the heart becomes weak, water and sodium accumulate in the tissues and cause a fluid congestion. This congestion puts further strains on the circulatory system.

In systolic type CHF, fluid accumulates in the lungs (pulmonary congestion), and in the diastolic type of CHF, fluid accumulates in the feet, ankles, legs, and abdomen. It is also possible for patients to have heart failure without any symptoms of congestion.

Congestive Heart Failure is a clinical syndrome, which can be caused by a myriad of underlying disorders. These include, and are not limited to; diabetes, chronic lung disease (asthma or emphysema), and other types of cardiac disease (heart attacks, coronary artery disease, rheumatic heart disease, or heart valve disorder).

Other risk factors include smoking, physical inactivity, high cholesterol, and obesity. Congestive Heart Failure is the most common cause for hospitalization in patients over the age of 65, and affects more men than women. CHF also affects twice as many African-Americans as Caucasians, with twice the mortality rate.

Congestive Heart Failure Symptoms

The general symptoms of Congestive Heart Failure include:

  • Weakness
  • Shortness of Breast (dyspnea)
  • Fluid Accumulation (edema in feet, ankles, legs, and/or abdomen)
  • Exercise intolerance (shortness of breast with daily activity)
  • Persistent coughing (blood may be present in sputum)
  • Cardiac asthma (shortness of breath when lying down)

Congestive Heart Failure Statistics

According to the American Heart Association (1):

  • Approximately 5 million Americans have Congestive Heart Failure.
  • An estimated 500,000 new cases of CHF will be diagnosed this year.
  • About 80% of men and 70% of women diagnosed with Congestive Heart Failure will die within 8 years.

Congestive Heart Failure (CHF) Treatment

Congestive Heart Failure may be evaluated by electrocardiogram (ECG), echocardiogram, and chest x-rays. Treatment varies, and is directly influenced by the underlying health condition or problem that may be causing CHF, such as hypertension or diabetes. Various medications may be prescribed for Congestive Heart Failure. Angiotensin-converting enzyme, or ACE inhibitors; vasodilators to expand blood vessels; beta-blockers to reduce left ventricular oxygen demand; digitalis to increase heart pumping rhythm; and diuretics to eliminate fluid accumulation are all common approaches in the modern treatment of this condition.

Supplements helpful for Congestive Heart Failure

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) is a naturally occurring nutrient that boosts cellular energy production in the mitochondria, the cell’s energy powerhouse. Several studies have found that CoQ10 supplementation energizes the heart muscle, decreases chest congestion, and may protect against congestive heart failure (2-4). Other studies report that CoQ10 supplementation may significantly improve heart function in patients with CHF when used as an adjunct to conventional drug therapy, than results obtained from conventional drug therapy alone (5, 6).


Magnesium is often low in patients with congestive heart failure. A deficiency of this mineral can lead to irregular heartbeat and coronary artery spasm (7). Supplementation with magnesium can significantly improve heart function in patients with Congestive Heart Failure when used as an adjunct to conventional drug therapy, more so than results obtained from conventional drug therapy alone (8-10).


Carnitine is a vitamin-like nutrient that boosts energy production through the breakdown of fats by the mitochondria. Several studies have shown that carnitine supplementation improves heart function in patients with CHF and can significantly improve heart function when used as an adjunct to conventional drug therapy (11-13, 6).


Hawthorne (Crataegus sp.) is an herb that has been widely used in Europe for heart and circulatory problems. Studies have demonstrated the effectiveness of hawthorne supplementation in treating early stages of Congestive Heart Failure (14, 6).


Supplementation with the amino acid arginine has been shown to increase the body’s circulation by dilating blood vessels. Studies have shown that arginine supplementation improves heart function in patients with Congestive Heart Failure (15-17).

Human Growth Hormone

Supplementation with human growth hormone may be of benefit in the treatment of Congestive Heart Failure. Several studies have shown that both the supplementation with human growth hormone alone, and in conjunction with conventional medications, improved hears function and clinical symptoms in patients with CHF (18- 22).


Taurine, a derivative of the amino acid cysteine, may be beneficial in patients with CHF. Supplementation with taurine has been shown to help improve heart function and protect heart muscle cells during heart surgery (23).


Potassium, a nutritional mineral, is often low in patients with congestive heart failure, which can lead to irregular heart rhythms (24). Low potassium levels are often due to prescribed cardiovascular drugs, such as loop and thiazide diuretics and some calcium channel blockers. Supplementation with potassium to maintain blood potassium levels can help prevent potassium loss and irregular heart rhythms (25, 26).

Vitamin E

Vitamin E may be beneficial in patients with heart disease, such as CHF. Vitamin E supplementation helps to lower LDL (‘bad’) cholesterol levels, prevent LDL oxidation by free radicals, and prevent heart fibrillation. Eliminating these risk factors reduces the risks for developing atherosclerosis and helps to improve heart function (27, 28).

Essential fatty acids (Fish oil, Flax oil, Perilla oil)

Essential fatty acids, such as fish oil and flax oil, may be beneficial in patients with heart disease, such as CHF. Fish oil supplementation has been reported to help reduce plasma cholesterol levels, with the most significant decreases being in triglyceride levels. The many constituents of fish oils may improve the overall functioning of the heart (29, 30). Alpha-linolenic acid (perilla oil or flax oil) has been found to reduce the incidence of atherosclerosis, stroke, and second heart attacks (31).


1. Congestive Heart Failure:

2.Morisco C, et al. Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig. 1993;71(8 Suppl):S134-6.

3 Mortensen SA, et al. Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. Int J Tissue React. 1990;12(3):155-62.

4. Baggio E et al., Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Clin Investig 1993 71 (8 Suppl): S145-9

5. Ishiyama T et al., A clinical study of the effect of coenzyme Q on congestive heart failure. Jpn Heart J 1976 (17):32

6. Pizzorno JE and Murray MT, eds. Encyclopedia of Natural Medicine, revised 2nd edition, CA: Prima Publishing, 1998: 504-506.

7. Siembab L, et al. Current views on the clinical significance of coronary artery spasm. Przegl Lek. 1995;52(8):395-9.

8. Gottlieb SS et al. “Prognostic importance of serum magnesium concentration in patients with congestive heart failure, J Am Coll Cardiol 1990 (16): 827-31.

9. Gottlieb SS. Importance of magnesium in congestive heart failure. Am J Cardiol 1989 (63): 39G-42G.

10. McLean RM. Magnesium and its therapeutic uses: A review. Am J Med 1994 (96): 63-76.

11. Anand I, et al. Acute and chronic effects of propionyl-L-carnitine on the hemodynamics, exercise capacity, and hormones in patients with congestive heart failure. Cardiovasc Drugs Ther. Jul1998;12(3):291-9.

12. Mancini M et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneim Forsch 1992 (42): 1101-4

13. Pucciarelli G et al. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure. Clin Terr 1992 (141): 379-84.

14. Leuchtgens H. Crataegus Special Extract WS 1442 in NYHA II heart failure: A placebo controlled randomized double-blind study. Fortschr Med 1993 (111): 352-4.

15. Katz SD, et al. Decreased activity of the L-arginine-nitric oxide metabolic pathway in patients with congestive heart failure. Circulation. Apr1999;99(16):2113-7.

16. Bednarz B, Jaxa-Chamiec T, Gebalska J, Herbaczynska-Cedro K, Ceremuzynski L. L-arginine supplementation prolongs duration of exercise in congestive heart failure. Kardiol Pol. Apr2004;60(4):348-53.

17. Koifman B, et al. Improvement of cardiac performance by intravenous infusion of L-arginine in patients with moderate congestive heart failure. J Am Coll Cardiol. Nov1995;26(5):1251-6.

18. Jayasankar V et al. Local myocardial overexpression of growth hormone attenuates postinfarction remodeling and preserves cardiac function. Ann Thorac Surg. 2004 Jun;77(6):2122-9; discussion

19. Cicoira M et al. Growth hormone resistance in chronic heart failure and its therapeutic implications. J Card Fail. 2003 Jun;9(3):219-26. Review.

20. Dreifuss P, [Dilated cardiomyopathy and growth hormone] Z Kardiol. 2002 Dec;91(12):973-7. Review. German.

21. Napoli R et al. J Am Coll Cardiol. 2002 Jan 2;39(1):90-5. Growth hormone corrects vascular dysfunction in patients with chronic heart failure.

22. Fazio S et al. A preliminary study of growth hormone in the treatment of dilated cardiomyopathy. N Engl J Med. 1996 Mar 28;334(13):809-14.

23. Suleiman MS et al. A loss of taurine and other amino acids from ventricles of patients undergoing bypass surgery. Br Heart J. 1993 Mar;69(3):241-5.

24. Packer M. Potential role of potassium as a determinant of morbidity and mortality in patients with systemic hypertension and congestive heart failure. Am J Cardiol. Mar1990;65(10):45E-52E.

25. Lindeman RD. Hypokalemia: Causes, Consequences and Correction. Am J Med Sci. Aug 1976;272(1):5-17.

26. Francis GS. Interaction of the sympathetic nervous system and electrolytes in congestive heart failure. Am J Cardiol. Mar1990;65(10):24E-27E, 52E.

27. Chan AC. Vitamin E and atherosclerosis. J Nutr. 1998;128(10):1593-6.

28. Stephens NG, et al. Randomised controlled trial of vitamn E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996 Mar 23;347(9004):781-6.

29. Tsai PJ, Lu SC. Fish oil lowers plasma lipid concentrations and increases the susceptibility of low density lipoprotein to oxidative modification in healthy men. J Formos Med Assoc 1997 96(9): 718-26.

30. Morcos NC. Modulation of lipid profile by fish oil and garlic combination. J Natl Med Assoc 1997 89(10): 673078.

31. Oh-hashi K et al. Possible mechanisms for the differential effects of high linoleate safflower oil and high alpha-linolenate perilla oil diets on platelet-activating factor production by rat polymorphonuclear leukocytes. J Lipid Mediat Cell Signal. 1997 Dec;17(3):207-20

32. Life Extension eds., Disease Prevention and Treatment, 4th ed. Florida: Life Extension Media, 2003