Usually, the loss in the heart’s pumping action is a symptom of an underlying heart problem.
Heart valve disease caused by past rheumatic fever or other infections
Infections of the heart valves and/or heart muscle (i.e., endocarditis)
Cardiac arrhythmias (irregular heartbeats)
Cardiomyopathy, or another primary disease of the heart muscle
Chronic lung disease
Anemia
High blood pressure (hypertension)
Hemorrhage (excessive bleeding)
CHF leads to breathlessness, fatigue, and accumulation of fluid in the lungs or the veins (primarily in the legs) or both.
People with CHF have insufficient oxygenation of the heart, which can damage the heart muscle. Such damage may be reduced by taking L-carnitine supplements.5 L-carnitine is a natural substance made from the amino acids, lysine and methionine. Levels of L-carnitine are low in people with CHF;6 therefore, many doctors recommend that those with CHF take 500 mg of L-carnitine two to three times per day.
Most L-carnitine/CHF research has used a modified form of the supplement called propionyl-L-carnitine (PC). In one double-blind trial, people using 500 mg of PC per day had a 26% increase in exercise capacity after six months.7 In double-blind research, other indices of heart function have also improved after taking 1 gram of PC twice per day.8 It remains unclear whether propionyl-L-carnitine has unique advantages over L-carnitine, as limited research in animals and humans has also shown very promising effects of the more common L-carnitine.9
Magnesium deficiency frequently occurs in people with CHF, and such a deficiency may lead to heart arrhythmias. Magnesium supplements have reduced the risk of these arrhythmias.10 People with CHF are often given drugs that deplete both magnesium and potassium; a deficiency of either of these minerals may lead to an arrhythmia.11 Many doctors suggest magnesium supplements of 300 mg per day.
Whole fruit and fruit and vegetable juice, which are high in potassium, are also recommended by some doctors. One study showed that elderly men who consumed food prepared with potassium-enriched salt (containing about half potassium chloride and half sodium chloride) had a 70% reduction in deaths due to heart failure and a significant reduction in medical costs for cardiovascular disease, when compared with men who continued to use regular salt.12 While increasing potassium intake can be beneficial for heart patients, this dietary change should be discussed with a healthcare provider, because several drugs given to people with CHF may actually cause retention of potassium, making dietary potassium, even from fruit, dangerous.
Albany Medical Center is the first healthcare institution in the region to introduce aquapheresis-an innovative therapy which removes dangerous levels of excess fluid in patients suffering from congestive heart failure. The therapy has proven to be more effective in removing excess fluid than standard treatment and reduces the likelihood of re-hospitalization for congestive heart failure.
According to Edward Philbin, M.D., medical director of the Heart Failure Program and George Pataki Chair in Cardiology at Albany Medical Center, heart failure is characteristically accompanied by significant fluid retention. Aquapheresis is the first major advancement for acute fluid removal in the setting of acute heart failure since the introduction of diuretics, more than 50 years ago.
Aquapheresis uses the process of ultrafiltration to remove excess sodium and water from the body. Blood is withdrawn through a catheter and circulated through the filter system that separates the fluids from the blood. Once filtered, the clean blood is returned back to the body through a second catheter. Aquapheresis uses a peripheral intravenous line (a catheter inserted into a vein in the arm). By using this system, up to four liters of fluid can be removed in an eight-hour period, with no significant impact on blood pressure, kidney function, or electrolyte balance.
Conversely, treatment for congestive heart failure using intravenous or oral diuretic drugs can cause decreases in blood pressure and levels of potassium or magnesium, and may cause disruption of normal kidney function. Moreover, diuretics can take a longer period of time than aquapheresis to be completely effective. Overall, aquapheresis removes more fluid, more rapidly, than standard treatment with diuretics alone.
Even with severe disease, appropriate exercise can benefit those with CHF.1, 2 In a controlled trial, long-term (one year) exercise training led to improvements in quality of life and functional capacity in people with CHF.3 Nonetheless, too much exercise can be life-threatening for those with CHF. How much is “too much” varies from person to person; therefore, any exercise program undertaken by someone with CHF requires professional supervision.
