Dietary intervention with a specific micronutrient combination for the treatment of patients with cardiac arrhythmias: the impact on insulin resistance and left ventricular function

Elke Parsi, Norman Bitterlich, Anne Winkelmann, Daniela Rösler, Christine Metzner, Elke Parsi, Norman Bitterlich, Anne Winkelmann, Daniela Rösler, Christine Metzner

Abstract

Background: Cardiac arrhythmias (CA) are very common and may occur with or without heart disease. Causes of these disturbances can be components of the metabolic syndrome (MetS) or deficits of micronutrients especially magnesium, potassium, B vitamins and coenzyme Q10. Both causes may also influence each other. Insulin resistance (IR) is a risk factor for diastolic dysfunction. One exploratory outcome of the present pilot study was to assess the impact of a dietary intervention with specific micronutrients on the lowering of IR levels in patients with CA with the goal to improve the left ventricular (LV) function.

Methods: This was a post hoc analysis of the randomized double blind, placebo-controlled pilot study in patients with CA (VPBs, SVPBs, SV tachycardia), which were recruited using data from patients who were 18-75 years of age in an Outpatient Practice of Cardiology. These arrhythmias were assessed by Holter ECG and LV function by standard echocardiography. Glucose metabolism was measured by fasting glucose, fasting insulin level and the Homeostasis Model Assessment of IR (HOMA-IR) at baseline and after 6 weeks of dietary supplementation.

Results: A total of 54 randomized patients with CA received either a specific micronutrient combination or placebo. Dietary intervention led to a significant decrease in fasting insulin ≥58 pmol/l (p = 0.020), and HOMA-IR (p = 0.053) in the verum group after 6 weeks. At the same time, parameters of LV diastolic function were improved after intervention in the verum group: significant reduction of LV mass index (p = 0.003), and in tendency both a decrease of interventricular septal thickness (p = 0.053) as well as an increase of E/A ratio (p = 0.051). On the other hand, the premature beats (PBs) were unchanged under verum.

Conclusions: In this pilot study, dietary intervention with specific micronutrient combination as add-on to concomitant cardiovascular drug treatment seems to improve cardio metabolic health in patients with CA. Further studies are required.

Study registration: The study was approved by the Freiburg Ethics Commission International and was retrospectively registered with the U.S. National Institutes of Health Clinical Trials gov ID NCT 02652338 on 16 December 2015.

Trial registration: ClinicalTrials.gov NCT02652338.

Keywords: Diastolic LV function; Dietary intervention; Glucose metabolism; LVMI; Premature beats.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Freiburg Ethics Commission International. All patients gave written informed consent to take part in this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. EP received grants as consultant and as speaker for Trommsdorff.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Trial Profile
Fig. 2
Fig. 2
Study schedule. Recruiting / Start of run-in period: At the first visit the patients were informed about the study in detail and the necessary examinations for inclusion and exclusion criteria were carried out. If the criteria were met and the patient gave his written consent to participate in the study, the placebo tablets for the run-in phase were issued at the second visit. Baseline: Inclusion and exclusion criteria were once again checked, then the patients were randomized. In addition anthropological parameters were collected at each visit. Abbreviations used: E, echocardiography; ECG, electrocardiogramm; ECGr, ECG at rest; ECGh, Holter ECG; FR, 3-day food record; BU, Blood and urinary samples

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