A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure

Background: Oxidative stress is increased in patients with congestive heart failure and can contribute to the progressive deterioration observed in th ese patients. Increased oxidative stress is the result of either an increas ed production of free radicals or a depletion of endogenous antioxidants, s uch as vitamin E. Objective: We aimed to determine whether vitamin E supplementation of patie nts with advanced heart failure would modify levels of oxidative stress, th ereby preventing or delaying the deterioration associated with free radical injury. Design: Fifty-six outpatients with advanced heart failure (New York Heart A ssociation functional class III or IV) were enrolled in a double-blind rand omized controlled trial for 12 wk. At a baseline visit and at 2 follow-up v isits, blood and breath samples were collected fur the measurement of index es of heart function and disease state, including malondialdehyde, isoprost anes, and breath pentane and ethane. Quality of life was also assessed at b aseline and after 12 wk of treatment. Results: Vitamin E treatment significantly increased plasma concentrations of alpha -tocopherol in the treatment group but failed to significantly aff ect any other marker of oxidative stress or quality of life. In addition, c oncentrations of atrial naturetic peptide (a humoral marker of ventricular dysfunction), neurohormonal-cytokine markers of prognosis, tumor necrosis f actor, epinephrine, and norepinephrine were unchanged with treatment and we re not significantly different from those in the control group. Conclusion: Supplementation with vitamin E did not result in any significan t improvements in prognostic or functional indexes of heart failure or in t he quality of life of patients with advanced heart failure.