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JohnWBurns
@johnwburns

Posts: 300
Joined: Jun 02, 2015

Left Ventricular Diastolic Dysfunction - pre heart failure, preserved

Posted by @johnwburns, Sep 22, 2016

I’m thinking here of people with a decline in left ventricular function with possibly associated symptoms like dyspnea on exertion and fatigue, but who still have a preserved ejection fraction, say >= 45%

Anyone know of anything that helps besides exercise?

I have seen supplements thrown around such as carnitine and hawthorn berry but nothing with dramatic advantages.

Some possible benefit from omega 3’s but, again, nothing very substantive, that I’ve seen anyway.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758087/

Any thoughts?

REPLY

My thoughts are on a different branch of this concern, Jim, so I won’t take much of your time. When my nephrologist suggested a strong beta blocker to treat my hypertension, I did some research and found a worry. Research into diastolic dysfunction (especially a project in which a Mayor cardiologist from Korea participated) popped into view with a warning that beta blockers were a threat to those with diastolic dysfunction. So I talked to my cardiologist about whether the beta blocker was a bad idea.

Not at all, he said. “You have a-fib which is, by definition, diastolic dysfunction, and we often use beta blockers in such cases.” Turns out the risk from beta blockers occurs when the diastolic dysfunction is caused by something other than a-fib (giving me another lesson in reading medical research reports carefully).

So I agreed to the new medication (Carvedilol, which is a kidney-friendly beta blocker). You can see that I’m on the atrium branch of this tree, not the ventricle branch that is your focus. But one chamber succeeds the other, and the ventricular ejection fraction may be reduced when the atrium fails to fill and then deliver maximum blood (received from the lungs) into the ventricle for distribution to the body.

You’re looking for substances to ameliorate diastolic dysfunction. I found a lot of hope in the research report you cited from the National Institutes of Health. The second paragraph of the introduction gave me strong encouragement to get 3 or 4 grams of omega-3 fats every day, because the NIH study finds them to be useful in cases of congestive heart failure, which is my main concern since my a-fib diagnosis two years ago.

Hope you find something in my experience to raise your hopes as well.
Martin

@predictable

My thoughts are on a different branch of this concern, Jim, so I won’t take much of your time. When my nephrologist suggested a strong beta blocker to treat my hypertension, I did some research and found a worry. Research into diastolic dysfunction (especially a project in which a Mayor cardiologist from Korea participated) popped into view with a warning that beta blockers were a threat to those with diastolic dysfunction. So I talked to my cardiologist about whether the beta blocker was a bad idea.

Not at all, he said. “You have a-fib which is, by definition, diastolic dysfunction, and we often use beta blockers in such cases.” Turns out the risk from beta blockers occurs when the diastolic dysfunction is caused by something other than a-fib (giving me another lesson in reading medical research reports carefully).

So I agreed to the new medication (Carvedilol, which is a kidney-friendly beta blocker). You can see that I’m on the atrium branch of this tree, not the ventricle branch that is your focus. But one chamber succeeds the other, and the ventricular ejection fraction may be reduced when the atrium fails to fill and then deliver maximum blood (received from the lungs) into the ventricle for distribution to the body.

You’re looking for substances to ameliorate diastolic dysfunction. I found a lot of hope in the research report you cited from the National Institutes of Health. The second paragraph of the introduction gave me strong encouragement to get 3 or 4 grams of omega-3 fats every day, because the NIH study finds them to be useful in cases of congestive heart failure, which is my main concern since my a-fib diagnosis two years ago.

Hope you find something in my experience to raise your hopes as well.
Martin

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Well you are deeper into this area than I ever wanted to get so if you see some value I’ll weight it accordingly. The conclusion looked kind of tepid about possible benefits but variance across studies was noted. In the Discussion he says: “Although the improvements in the omega-3 supplementation group were small, the beneficial effects cannot be overlooked, and included improvements in the Tei and late diastolic velocity indices as markers of diastolic left ventricular function.”. Hey, “small” is better than nothing for this particular topic. I’m careful about omega 3 consumption because of the wandering results regarding prostate cancer, and because of my mistrust of the too-much-of-a-good-thing syndrome in general. Heart wise they seem much more benign if not outright beneficial. But, the most highly touted diet, the Mediterranean one, doesn’t put heavy emphasis on them as well. Speaking of that diet, olive oil is a relatively neglected lipid when it comes to being a heart tonic, if not a boost for a specific illness. I have grown to dislike pulling one thread too hard only to unravel another one. In lieu of a magic bullet, I prefer a somewhat proven modulator of all cause mortality.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198773/

In that vein, ever heard of this herb. I’ve looked at a lot and this one seems like one of the more promising.

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/nigella-sativa

Jim

As a world traveler, Jim, you’re better equipped to recognize Nigella. I never heard of it, even from my Indonesian friends. But it apparently has an ancient benefit of some note in subcontinent folk medicine. Might be interesting to try.

Olive oil is great, but has two shortcomings in my case: My wife doesn’t use it much to cook (nor do I, but then I don’t cook much either). In addition, there is so much criminality in the harvesting of olive oil that I’m never confident of its virginity. In women, who cares? But in olive oil? Gotta be reliably virgin.

@predictable

As a world traveler, Jim, you’re better equipped to recognize Nigella. I never heard of it, even from my Indonesian friends. But it apparently has an ancient benefit of some note in subcontinent folk medicine. Might be interesting to try.

Olive oil is great, but has two shortcomings in my case: My wife doesn’t use it much to cook (nor do I, but then I don’t cook much either). In addition, there is so much criminality in the harvesting of olive oil that I’m never confident of its virginity. In women, who cares? But in olive oil? Gotta be reliably virgin.

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World traveller? Not even close. Nigella just popped out on one of my pointless scans.
Wasn’t aware of any criminal underground controlling the olive oil trade but doesn’t surprise me. I’m told that you can rely on its potency if a teaspoonful burns the back of your throat when you swallow it. Who knows.
Ever heard of dried bonito for hypertension? I tend to trust Japanese research in this area. Not sure if its distribution is owned by the Yakuza.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257737/

Jim

Thanks for the tip on bonito, Jim. I’m a heavy user of fish muscle, mostly from shrimp, tuna, salmon, and lutefisk (Norwegian cod). Just learned about a Washiington DC restaurant that prepares a tuna steak so it looks and tastes like filet mignon, which I avoid as much as possible. That bonito and the other fish meats emulate ACE inhibitors is not a benefit for me — I’m already taking the daily maximum of 40mg of Lisinopril, thanks to my nephrologist’s concern for preservation of residual kidney function!
Martin

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@predictable

Thanks for the tip on bonito, Jim. I’m a heavy user of fish muscle, mostly from shrimp, tuna, salmon, and lutefisk (Norwegian cod). Just learned about a Washiington DC restaurant that prepares a tuna steak so it looks and tastes like filet mignon, which I avoid as much as possible. That bonito and the other fish meats emulate ACE inhibitors is not a benefit for me — I’m already taking the daily maximum of 40mg of Lisinopril, thanks to my nephrologist’s concern for preservation of residual kidney function!
Martin

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Martin,
In looking at the omega 3’s a one or more flavors of heart problems I seemed to see a recurrence of callouts of synergy between resveratrol and omega 3’s. No big studies but who knows. Too late to think about it but here’s one…

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675849/

Jim

Wow, Jim (@johnwburns), that review of studies into omega-3s and resveratrol open a big door to a warehouse full of research on a range of terminal illnesses! Even a-fib is reported by an Italian study to be treated by omega-3s, although no corroborating study has yet emerged on that. I’m moved to quantify and normalize my daily intake of omega-3s — for no other reason than the brain cells and retina cells that are strengthened by omega-3s. Heart benefits are a bonus to me. Resveratrol is another animal in this; I need a lot more information and encouragement about it — mostly because some nutritional and alternative medicine advisories have passed the word that it takes a huge amount of red wine (or other source like blueberries) to get a meaningful dose of resveratrol. One novel report I saw a few weeks ago said the benefits of resveratrol are cumulative over time, so if you live long enough, you can benefit without drinking a case of red wine (or eating a bushel of blueberries) every day. This conundrum needs my attention!

@predictable

Wow, Jim (@johnwburns), that review of studies into omega-3s and resveratrol open a big door to a warehouse full of research on a range of terminal illnesses! Even a-fib is reported by an Italian study to be treated by omega-3s, although no corroborating study has yet emerged on that. I’m moved to quantify and normalize my daily intake of omega-3s — for no other reason than the brain cells and retina cells that are strengthened by omega-3s. Heart benefits are a bonus to me. Resveratrol is another animal in this; I need a lot more information and encouragement about it — mostly because some nutritional and alternative medicine advisories have passed the word that it takes a huge amount of red wine (or other source like blueberries) to get a meaningful dose of resveratrol. One novel report I saw a few weeks ago said the benefits of resveratrol are cumulative over time, so if you live long enough, you can benefit without drinking a case of red wine (or eating a bushel of blueberries) every day. This conundrum needs my attention!

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Good, I hope it helps. I’m going to dump mine back up to ~2.5 gms/day and hope for the best. Remember they can suppress immunity but I’d guess that it takes a higher dose to do that. Potential cognitive bennies, mostly from DHA, are a perk I’m in need of. Grape and grape seed are also loaded with polyphenols that appear to have consistent benefit, or at least little chance of downside. You can buy resveratrol at pretty high concentrations at Costco. Going too high is always a bad idea anyway. That’s a good point re longevity. It takes a while to down regulate SIRT1 or whatever the master switch is. I thought about it and I’m going to avoid it. I’m past longevity and into survival and high doses of antioxidants don’t look like they enhance the probabilities. Let me know how your investigations progress.
Jim

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