Selenium, Selenoproteins, and Heart Failure: Current Knowledge and Future Perspective.

Area of Science:

• Cardiology and Nutritional Science
• Biochemistry and Molecular Biology

Background:

• Micronutrient malnutrition, particularly selenium deficiency, affects 30-50% of heart failure (HF) patients.
• Low selenium levels are linked to negative health outcomes, including Keshan disease in endemic areas.
• Selenium is crucial for the function of 25 selenoproteins involved in various biological processes.

Purpose of the Study:

• To review current evidence on selenium's role in heart failure.
• To explore potential mechanisms by which selenoproteins influence HF.
• To assess the need for further clinical trials on selenium supplementation in HF.

Main Methods:

• Literature review of studies on selenium, selenoproteins, and heart failure.
• Analysis of clinical trial data and epidemiological findings.
• Examination of the biochemical functions of selenoproteins in cardiac and systemic health.

Main Results:

• Over 70% of HF patients have suboptimal selenium levels (<100 μg/L), correlating with reduced exercise capacity and poorer prognosis.
• Small trials suggest selenium supplementation may improve HF symptoms, left ventricular ejection fraction, and lipid profiles.
• Selenoprotein dysfunction under low selenium conditions may worsen oxidative stress, inflammation, and thyroid issues in HF.

Conclusions:

• Current evidence does not support routine selenium supplementation for HF patients.
• Further high-level evidence is required to determine selenium's therapeutic role in HF.
• Selenoproteins play vital roles in mitochondrial integrity, oxidative stress reduction, and anti-inflammatory processes, with potential systemic benefits.