Marinescu Victor, McCullough Peter A
Department of Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Expert Rev Cardiovasc Ther. 2011 Sep;9(9):1161-70. doi: 10.1586/erc.11.95.
Idiopathic dilated cardiomyopathy (IDCM) is the term used to describe a group of myocardial diseases of unknown cause whose common clinical presentation is heart failure. The prevalence of IDCM is estimated to be between 7 and 13% of patients with systolic heart failure. Throughout medical history, several nutrient-deficient states have been identified as the root cause of IDCMs, Keshan's disease being one such example, where selenium deficiency-induced heart failure is now well documented. This raises the question of whether a micro- or macro-nutrient imbalance can provide the milieu for inefficient energy expenditure and cardiac metabolism in the context of IDCMs, either causing or exacerbating the condition. To date, there is insufficient evidence in the literature to support this theory, although numerous studies suggest a link between nutrient deficiencies, inefficient energy expenditure and subsequent heart failure. Given the unique metabolic needs of the failing heart, the role of micronutrient testing and supplementation in IDCMs warrants further well-designed studies.
特发性扩张型心肌病（IDCM）是用于描述一组病因不明的心肌疾病的术语，其常见临床表现为心力衰竭。据估计，IDCM在收缩性心力衰竭患者中的患病率为7%至13%。纵观医学史，几种营养缺乏状态已被确定为IDCM的根本原因，克山病就是这样一个例子，现在硒缺乏引起的心力衰竭已有充分记录。这就提出了一个问题，即微量或常量营养素失衡是否会在IDCM的情况下为能量消耗效率低下和心脏代谢提供环境，从而导致或加重病情。迄今为止，文献中没有足够的证据支持这一理论，尽管大量研究表明营养缺乏、能量消耗效率低下与随后的心力衰竭之间存在联系。鉴于衰竭心脏独特的代谢需求，微量营养素检测和补充在IDCM中的作用值得进一步开展精心设计的研究。
