Huang Lillian, Huhulea Ellen N, Enwere Chisom, Aifuwa Esewi, Frishman William H, Aronow Wilbert S
From the Department of Medicine, New York Medical College, Valhalla, NY.
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Cardiol Rev. 2025 Nov 3. doi: 10.1097/CRD.0000000000001110.
Nutritional deficiencies remain an important yet underrecognized cause of cardiovascular morbidity worldwide. Our review examines how deficiencies in key micronutrients and macronutrients lead to distinct cardiac manifestations, ranging from structural alterations to functional impairments. We begin with water-soluble vitamins, highlighting classic manifestations like thiamin deficiency and wet beriberi, later pyridoxine, folate, cobalamin, and ascorbic acid. Next, we discuss fat-soluble vitamins A, D, E, and K. We also address the role of minerals, including calcium, iodine, magnesium, potassium, selenium, zinc, and iron, each of which contributes to myocardial function, vascular regulation, or arrhythmogenic risk. Finally, we discuss macronutrients like proteins, fatty acids, and carbohydrates, and their broader influence on myocardial integrity and energy metabolism. Recognition of these nutritional contributors is essential for timely diagnosis and intervention, as many cardiac effects are reversible with supplementation. Importantly, a comprehensive approach must also account for social determinants of health, since nutritional deficiencies disproportionately affect vulnerable populations, particularly those with lower socioeconomic status. This review highlights the diverse spectrum of cardiac manifestations associated with nutritional deficiencies and underscores the importance of integrating nutritional assessment into cardiovascular care.
在全球范围内，营养缺乏仍然是心血管疾病发病的一个重要但未得到充分认识的原因。我们的综述探讨了关键微量营养素和宏量营养素的缺乏如何导致不同的心脏表现，从结构改变到功能障碍。我们首先从水溶性维生素开始，重点介绍硫胺素缺乏和湿性脚气病等经典表现，随后是吡哆醇、叶酸、钴胺素和抗坏血酸。接下来，我们讨论脂溶性维生素A、D、E和K。我们还阐述了矿物质的作用，包括钙、碘、镁、钾、硒、锌和铁，它们各自对心肌功能、血管调节或心律失常风险都有影响。最后，我们讨论蛋白质、脂肪酸和碳水化合物等宏量营养素，以及它们对心肌完整性和能量代谢的更广泛影响。认识到这些营养因素对于及时诊断和干预至关重要，因为许多心脏影响通过补充营养是可逆的。重要的是，全面的方法还必须考虑健康的社会决定因素，因为营养缺乏对弱势群体，特别是社会经济地位较低的人群影响尤为严重。本综述强调了与营养缺乏相关的心脏表现的多样性，并强调了将营养评估纳入心血管护理的重要性。
