The role of selenium deficiency in dilated cardiomyopathy in Saudi Arabia (original) (raw)
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Plasma and urinary selenium in Saudi Arabian patients with dilated cardiomyopathy
Biological Trace Element Research, 1999
We measured selenium (Se) levels in the urine and blood plasma samples of 72 Saudi Arabian patients with dilated cardiomyopathy (DCM) and 70 control subjects of the same origin. To correct for differences in the hydration state of the subjects, the selenium concentration for each urine sample was normalized by dividing it by the concentration of creatinine (CREAT) in the same sample. The median (and range) of the values found for the concentration of Se in plasma, urine, and normalized concentration in urine for the control subjects was 1.306 (0.66-2.50) ~M, 0.478 (0.05-2.00) gM, and 56.7 (10.6-426.5) gM Se/M CREAT, respectively, whereas, for the patients, it was 1.246 (0.53-2.45) gM, 0.39 (0.05-1.90) gM, and 75.1 (4.9-656.2) gM Se/M CREAT, respectively. Additionally, the patients were separated into three subgroups according to the severity of their disease state as judged by NYHA procedure, and were then compared to the control group. Only group 4 (the most severe state of the disease) had a significantly lower concentration of urinary Se than the control group. However, the difference became nonsignificant when normalized for CREAT levels. There was no significant difference in the plasma Se 60 Raines et al. levels between the controls and any of the patient groups. As the plasma Se in the control group and in the DCM patients both fell on the low end of the "normal" range, with the patients being marginally lower than the controls, there is no firm evidence from this study to suggest that Se is related to the high incidence rate of DCM found in Saudi Arabia.
Selenium: a brief review and a case report of selenium responsive cardiomyopathy
BMC Pediatrics, 2013
Background: The authors review the role of selenium and highlight possible low selenium levels in soil that may result in deficient states in Saudi Arabia. Case presentation: The authors report a case of selenium-responsive cardiomyopathy in a 15-month old Saudi Arabian boy. This case of selenium deficiency causing dilated cardiomyopathy is presented with failure to thrive, prolonged fever and respiratory distress. The investigations revealed selenium deficiency. Selenium supplementation along with anti-failure therapy [Furosimide, Captopril] was administered for 6 months. Following therapy the cardiac function, hair, skin and the general health of the patient improved significantly. Conclusion: The patient with dilated cardiomyopathy of unknown etiology, not responding to usual medication may be deficient in selenium. Serum selenium measurements should be included in the diagnostic work-up to ensure early detection and treatment of the disease. The selenium level in the Saudi population needs be determined. Vulnerable populations have to undergo regular selenium measurements and supplementation if indicated. Dependence on processed foods suggests that the Saudi population fortify themselves with nutrient and micronutrient supplements in accordance to the RDA.
Congestive cardiomyopathy and the selenium content of serum
Clinica Chimica Acta, 1983
A deficiency of selenium is suspected to be involved in the pathogenesis of congestive cardiomyopathy. Therefore the serum selenium content of 20 patients with proven congestive cardiomyopathy was measured and compared to that of a healthy control group. The serum selenium content of the patients with cardiomyopathy was found to be different from that of the healthy control group. The mean value of selenium in serum for the control group was 80.1 pg Se/l (SD + 13.2) within a range of 53 and 117 pg Se/l. From the 20 patients with congestive cardiomyopathy six patients showed selenium concentrations in the normal value range of the control group; in the serum of 14 patients a distinct lower selenium content was found (mean value 47.8 pg Se/l (SD + 16.2)) within a range of 23 and 70 pg Se/l. A positive correlation was found between serum selenium content and the left ventricular ejection fraction. Our results suggest that a deficiency of selenium may be present in a number of patients with congestive cardiomyopathy.
Cardiomyopathy associated with nonendemic selenium deficiency in a Caucasian adolescent
The American journal of clinical nutrition, 1990
We describe a girl aged 17 y who died after a cardiac arrest secondary to septic shock. At autopsy, the enlarged, soft, and flabby heart showed microscopic evidence of acute myocardial infarction, myocardial edema, myocardiocyte loss, replacement fibrosis in the interventricular septum, and right and left ventricular hypertrophic nucleomegaly. The pathological diagnosis was that of cardiomyopathy due to prolonged selenium deficiency. The patient had been on total parenteral nutrition for 17 mo, following extensive bowel resection for intractable pain, nausea, and vomiting caused by chronic idiopathic intestinal pseudoobstruction. Seven months before death, when severe biochemical selenium deficiency was diagnosed, supplemental selenium was added to the infusion, and plasma selenium concentrations increased. In long-standing selenium deficiency, sepsis may contribute the final insult to a damaged myocardium, triggering symptomatic cardiac failure and sudden death.
The journal of Tehran Heart Center, 2012
Selenium (Se) is an essential trace element mainly obtained from seafood, meat, and cereals. Se deficiency has been identified as a major contributing factor in the pathogenesis of certain congestive heart failure (CHF) syndromes. Since there is controversy over the prevalence of Se deficiency among patient with CHF, the aim of this study was to assess the serum Se concentrations in patients with CHF and compared them with the Se status of healthy controls. The study included 77 patients (age, 68.4 ± 10.4 years old; 40.3% female) and 73 healthy volunteers (64.9 ± 4.7 years old; 35.6% female). A complete medical/drug history and physical examination were performed for all patients and healthy volunteers. All patients had symptoms and signs of CHF and had a left ventricular ejection fraction (EF) of < 40% obtained by echocardiography. The Se concentration was assessed by atomic absorption spectrometer with the Graphite Tube Atomizer. The limit of measurement was 5 μg/L. The Se conc...
Selenium deficiency associated porcine and human cardiomyopathies
Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS), 2014
Selenium (Se) is a trace element playing an important role in animal and human physiological homeostasis. It is a key component in selenoproteins (SeP) exerting multiple actions on endocrine, immune, inflammatory and reproductive processes. The SeP family of glutathione peroxidases (GSH-Px) inactivates peroxides and thereby maintains physiological muscle function in humans and animals. Animals with high feed conversion efficiency and substantial muscle mass have shown susceptibility to Se deficiency related diseases since nutritional requirements of the organism may not be covered. Mulberry Heart Disease (MHD) in pigs is an important manifestation of Se deficiency often implicating acute heart failure and sudden death without prior clinical signs. Post-mortem findings include hemorrhagic and pale myocardial areas accompanied by fluid accumulation in the pericardial sac and pleural cavity. Challenges in MHD are emerging in various parts of the world. Se is of fundamental importance a...
Selenium and outcome in heart failure
European Journal of Heart Failure, 2019
AimsSevere deficiency of the essential trace element selenium can cause myocardial dysfunction although the mechanism at cellular level is uncertain. Whether, in clinical practice, moderate selenium deficiency is associated with worse symptoms and outcome in patients with heart failure is unknown.Methods and resultsBIOSTAT‐CHF is a multinational, prospective, observational cohort study that enrolled patients with worsening heart failure. Serum concentrations of selenium were measured by inductively coupled plasma mass spectrometry. Primary endpoint was a composite of all‐cause mortality and hospitalization for heart failure; secondary endpoint was all‐cause mortality. To investigate potential mechanisms by which selenium deficiency might affect prognosis, human cardiomyocytes were cultured in absence of selenium, and mitochondrial function and oxidative stress were assessed. Serum selenium concentration (deficiency) was <70 μg/L in 485 (20.4%) patients, who were older, more often...
Risk of Myocardial Infarction in Relation to Serum Concentrations of Selenium
Acta Pharmacologica et Toxicologica, 1986
A number of variables are consistently found to be associated with increased risk for coronary heart disease (CHD). However, so far it has not been possible to increase the sensitivity much beyond 50 % when indenfifying the upper fifth of the total CHD risk distribution. This may be due both to the intraindividual variation of the risk factors, the random error of the measurements and the occurence of still unidentified risk factors.
Selenium and Cardiometabolic Health: Inconclusive Yet Intriguing Evidence
The American Journal of the Medical Sciences, 2013
Selenium is incorporated as the unique amino-acid selenocysteine into selenoproteins, which regulate important biologic processes such as redox balance. The results of epidemiologic and clinical investigations are inconclusive regarding the relation of the plasma selenium level to cardiometabolic parameters, and does not support the routine use of selenium supplements to prevent cancer or cardiovascular disease. Variability in the selenium status of the populations studied and lack of standardization of measures of selenium status may account for part of the confusion regarding selenium and cardiometabolic health. Another possibility is that differences in the effects of selenoproteins as opposed to those of low molecular weight selenium compounds derived from in vivo metabolism of selenium, may explain the unusual phenomenon of a similar phenotype induced by both selenium deficiency and excess in experimental models, as well as offer a plausible explanation for the lack of consistency in clinical studies. The epidemiologic, clinical, and experimental evidence, though inconclusive in terms of the precise relation of selenium to cardiometabolic health, is however, very intriguing in terms of the urgent need for further mechanistic research to enable the clinical use of this potent micronutrient.