Cardiomyopathy

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Cardiomyopathy

Need to Know

Cardiomyopathy
Breathe easier and return your heart to better health by dealing with the damage caused by cardiomyopathy. According to research or other evidence, the following self-care steps may be helpful.
  • See a specialist

    Consult a cardiologist for advice on treating your type of cardiomyopathy and its underlying causes

  • Count on coenzyme Q10

    At mealtime, take 100 to 150 mg a day of this powerful antioxidant to improve quality of life, heart function, and survival rates

  • Get help from hawthorn

    Relieve heart failure symptoms associated with cardiomyopathy by taking 160 to 900 mg a day of a standardized extract of this heart-healthy herb

  • Kick the habits

    Prevent cardiomyopathy and its complications by limiting or giving up alcohol and ending your addiction to cigarettes

  • Discover arjun

    Improve heart function by taking 500 mg of a concentrated extract of this herb three times a day

About

About This Condition

Cardiomyopathy refers to abnormalities in the structure or function of the heart muscle. There are three major types of cardiomyopathy: dilated congestive, hypertrophic, and restrictive.

The most prevalent form is dilated congestive cardiomyopathy (DCM). In people with DCM, the heart muscle is damaged, most commonly by coronary artery disease (atherosclerosis).1 People with diabetes have been reported to be at increased risk of DCM.2 DCM can also be triggered by alcohol abuse, infections, exposure to certain drugs and toxins, nutritional deficiencies, connective tissue diseases, hereditary disorders, and pregnancy.

In DCM, the heart gradually loses its efficiency as a pump. Cardiomyopathy is a serious health condition and requires expert medical care rather than self-treatment. However, because of the associations between cardiomyopathy and diseases such as atherosclerosis, diabetes, hypertension, and congestive heart failure, lifestyle recommendations for the prevention of these conditions may also help prevent DCM.

Hypertrophic cardiomyopathy is usually a hereditary disorder, although the incidence of this form of cardiomyopathy may also be higher in people with hypertension.3 Restrictive cardiomyopathy is usually due to a connective tissue disease, cancer, or an autoimmune condition. Both hypertrophic and restrictive cardiomyopathies are relatively uncommon.

Symptoms

People with cardiomyopathy may have difficulty breathing during light exertion, and they may become fatigued easily. Other chronic symptoms are swelling around the ankles and an enlarged abdomen.

Supplements

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


Supplement Amount Why
Arjun
 500 mg of a concentrated extract three times per day 2 stars   Arjun has been shown to significantly improve the signs and symptoms of cardiomyopathy, as well as the objective measurements of heart function.

2 stars  Arjun

500 mg of a concentrated extract three times per day

Two herbs used in the traditional medicine of India (Ayurveda) to treat people with cardiomyopathy and congestive heart failure have recently been supported by a small amount of clinical research. Arjun (Terminalia arjuna) has been shown to significantly improve the signs and symptoms of cardiomyopathy, as well as the objective measurements of heart function.4 In a clinical trial, people with dilated congestive cardiomyopathy (DCM) and severe heart failure took 500 mg of arjun extract three times daily. After two weeks, significant improvement in heart function was observed, an effect that continued over the course of approximately two years.5 The arjun used in this study was concentrated, but not standardized for any particular constituent. Commercial preparations are sometimes standardized to contain 1% arjunolic acid.


Supplement Amount Why
Coenzyme Q10
 100 to 150 mg daily 2 stars   Most studies using coenzyme Q10 in treating cardiomyopathy have shown positive results, including improved quality of life, heart function tests, and survival rates.

2 stars  Coenzyme Q10

100 to 150 mg daily

People with dilated congestive cardiomyopathy (DCM) have been shown to be deficient in coenzyme Q10.6 Most studies using coenzyme Q10 in the treatment of cardiomyopathy have demonstrated positive results, including improved quality of life, heart function tests, and survival rates.7 , 8 , 9 Coenzyme Q10 also has been shown to improve cardiac function in people with hypertrophic cardiomyopathy—a less common form of cardiomyopathy.10 A few studies, however, have found no benefit from CoQ10 supplementation in treating people with cardiomyopathy.11 , 12 Despite a lack of consistency in the outcomes of published research, many doctors recommend that 100 to 150 mg be taken each day, with meals.


Supplement Amount Why
Hawthorn
(Congestive Heart Failure)
 160 to 900 mg daily of a standardized herbal extract with a doctor's supervision 2 stars   Studies have found hawthorn to be effective for the signs and symptoms of early-stage congestive heart failure, the main complication of cardiomyopathy.

2 stars  Hawthorn

160 to 900 mg daily of a standardized herbal extract with a doctor's supervision

Many doctors expert in herbal medicine consider hawthorn to be an effective and low-risk therapy for congestive heart failure, the main complication of cardiomyopathy. Rigorous clinical trials have now confirmed the effectiveness of hawthorn for the signs and symptoms of early-stage congestive heart failure,13 , 14 , 15 , 16 , 17 though hawthorn studies with cardiomyopathy patients have yet to be conducted. The clinical trials with heart-failure patients have demonstrated efficacy using 80 to 300 mg of standardized extract of hawthorn leaves and flowers two to three times per day.


Supplement Amount Why
Coleus
 Refer to label instructions 1 star   Coleus contains forskolin, a substance that may help dilate blood vessels and improve the forcefulness with which the heart pumps blood.


1 star  Coleus

Another Ayurvedic herb, coleus, contains forskolin, a substance that may help dilate blood vessels and improve the forcefulness with which the heart pumps blood.18 Recent clinical studies indicate that forskolin improves heart function in people with cardiomyopathy and congestive heart failure.19 , 20 A preliminary trial found that forskolin reduced blood pressure and improved heart function in people with cardiomyopathy. These trials used intravenous injections of isolated forskolin. It is unknown whether oral coleus extracts would have the same effect. While many doctors and practitioners of herbal medicine would recommend 200 to 600 mg per day of a coleus extract containing 10% forskolin, these amounts are extrapolations and have yet to be confirmed by direct clinical research.

Supplement Amount Why
Dan Shen
 Refer to label instructions 1 star   Dan shen may improve the force of heart contractions and coronary circulation, and may prevent damage to the heart muscle that might lead to cardiomyopathy.

1 star  Dan Shen

Dan shen (Salvia miltiorrhiza), a Chinese herb, has been traditionally used to treat angina and coronary artery disease. Some studies suggest that dan shen may improve the force of heart contractions and coronary circulation, and may prevent damage to the heart muscle that might lead to cardiomyopathy.21 , 22 , 23 However, no clinical trials of dan shen for DCM have been reported. Doctors expert in Chinese herbal medicine typically recommend 1 to 6 grams per day of dried root.

Supplement Amount Why
Selenium
(Keshan's Cardiomyopathy)
 Refer to label instructions 1 star   Supplementing with selenium can correct selenium deficiency, which is believed to be a cause of Keshan’s disease, a form of cardiomyopathy found in China.


1 star  Selenium

Selenium deficiency has occasionally been reported as a cause of cardiomyopathy.24 , 25 Selenium deficiency is the probable cause of Keshan’s disease, a form of cardiomyopathy found in China26 , 27 but only rarely reported in the United States.28 Studies comparing populations in parts of the world other than mainland China have not supported a link between selenium deficiency and DCM,29 , 30 except in Taiwan.31 Moreover, no clinical trials outside of China have explored the effects of supplementation with selenium for people with DCM, nor is there reason to believe that selenium supplementation would help most people outside of China and Taiwan suffering from cardiomyopathy.

Supplement Amount Why
Taurine
 Refer to label instructions 1 star   Taurine has been shown in preliminary studies to be beneficial for cardiomyopathy.

1 star  Taurine

Several veterinary studies have demonstrated benefits from supplementation with taurine, another amino acid, in animals with cardiomyopathy. Most of these studies showed taurine deficiency to be a cause of cardiomyopathy. Taurine supplementation in animals with DCM has resulted in improvement of symptoms and survival rates.32 , 33 However, clinical studies in humans are lacking; thus, despite a good safety record, the benefits of taurine supplementation in people with any form of cardiomyopathy remain speculative. When taurine supplements are used by doctors to treat people with other conditions, 2 grams taken three times per day for a total of 6 grams per day is often recommended.

Supplement Amount Why
Vitamin B1
(Wet Beri Beri)
 Refer to label instructions 1 star   People with cardiomyopathy caused by severe vitamin B1 deficiency (known as wet beri beri) generally require intravenous vitamin B1, followed by oral supplementation.

1 star  Vitamin B1

The small proportion of people with cardiomyopathy whose disease is due to severe vitamin B1 (thiamine) deficiency (known as wet beri beri) generally require intravenous vitamin B1, followed by oral supplementation. Vitamin B1 does not appear to be helpful for other types of cardiomyopathy. People requiring vitamin B1 for cardiomyopathy must first be diagnosed as having wet beri beri, and treatment must be supervised by a healthcare professional.

References

1. Beers MH and Berkow R, eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck and Co., Inc., 1999, 1692.

2. Coughlin SS, Pearle DL, Baughman KL, et al. Diabetes mellitus and risk of idiopathic dilated cardiomyopathy. The Washington, DC Dilated Cardiomyopathy Study. Ann Epidemiol 1994;4(1):67–74.

3. Post WS, Larson MG, Levy D. Hemodynamic predictors of incident hypertension. The Framingham Heart Study. Hypertension 1994;24(5):585–90.

4. Dwivedi S, Jauhari R. Beneficial effects of Terminalia arjuna in coronary artery disease. Indian Heart J 1997;49:507–10.

5. Bharani A, Ganguly A, Bhargava KD. Salutary effect of Terminalia Arjuna in patients with severe refractory heart failure. Int J Cardiol 1995;49:191–9.

6. Manzoli U, Rossi E, Littarru GP, et al. Coenzyme Q10 in dilated cardiomyopathy. Int J Tissue React 1990;12(3):173–8.

7. Pogessi L, Galanti G, Comeglio M, et al. Effect of coenzyme Q10 on left ventricular function in patients with dilative cardiomyopathy. Curr Ther Res 1991;49:878–86.

8. Langsjoen PH, Vadhanavikit S, Folkers K. Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10. Proc Natl Acad Sci U S A 1985;82:4240–4.

9. Ma A, Zhang W, Liu Z. Effect of protection and repair of injury of mitochondrial membrane-phospholipid on prognosis in patients with dilated cardiomyopathy. Blood Press Suppl 1996;3:53–5.

10. Belardinelli R, Georgiou D, Cianci G, et al. Effects of exercise training on left ventricular filling at rest and during exercise in patients with ischemic cardiomyopathy and severe left ventricular systolic dysfunction. Am Heart J 1996;132(1 Pt 1):61–70.

11. Bresolin N, Doriguzzi C, Ponzetto C, et al. Ubidecarenone in the treatment of mitochondrial myopathies: a multi-center double-blind trial. J Neurol Sci 1990;100:70–8.

12. Permanetter B, Rossey W, Weingartner F, et al. Lack of effectiveness of coenzyme Q10 (Ubiquinone) in long-term treatment of dilated cardiomyopathy. Z Kardiol 1989;78:360–5 [in German].

13. Weikl A, Assmus KD, Neukum-Schmidt A, et al. Crataegus Special Extract WS 1442. Assessment of objective effectiveness in patients with heart failure. Fortschr Med 1996;114:291–6 [in German].

14. Weihmayr T, Ernst E. Therapeutic effectiveness of Crataegus. Fortschr Med 1996;114:27–9 [in German].

15. Leuchtgens H. Crataegus Special Extract WS 1442 in NYHA II heart failure. A placebo controlled randomized double-blind study. Fortschr Med 1993;111:352–4 [in German].

16. Schmidt U, Kuhn U, Ploch M, Hübner WD. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed 1994;1:17-24.

17. Pittler M, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev 2008 Jan 23;CD005312.

18. Lindner E, Dohadwalla AN, Bhattacharya BK. Positive inotropic and blood pressure lowering activity of a diterpene derivative isolated from Coleus forskohli: forskolin. Arzneimittelforschung 1978;28:284–9.

19. Baumann G, Felix S, Sattelberger U, Klein G. Cardiovascular effects of forskolin (HL 362) in patients with idiopathic congestive cardiomyopathy—a comparative study with dobutamine and sodium nitroprusside. J Cardiovasc Pharmacol 1990;16:93–100.

20. Kramer W, Thormann J, Kindler M, Schlepper M. Effects of forskolin on left ventricular function in dilated cardiomyopathy. Arzneimittelforschung 1987;37:364–7.

21. Takeo S, Tanonaka K, Hirai K, et al. Beneficial effect of tan-shen, an extract from the root of Salvia, on post-hypoxic recovery of cardiac contractile force. Biochem Pharmacol 1990 40:1137–43.

22. Bai YR, Wang SZ. Hemodynamic study on nitroglycerin compared with Salvia miltiorrhiza. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih 1994;14:24–5 [in Chinese].

23. Xing ZQ, Zeng XC, Yi CT. Effect of Salvia miltiorrhiza on serum lipid peroxide, superoxide dismutase of the patients with coronary heart disease. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih 1996;16:287–8 [in Chinese].

24. Auzepy P, Blondeau M, Richard C, et al. Serum selenium deficiency in myocardial infarction and congestive cardiomyopathy. Acta Cardiol 1987;42:161–6.

25. Oster O, Prellwitz W, Kasper W, Meinertz T. Congestive cardiomyopathy and the selenium content of serum. Clin Chim Acta 1983;29(128):125–32.

26. Xu GL, Wang SC, Gu BQ, et al. Further investigation on the role of selenium deficiency in the aetiology and pathogenesis of Keshan disease. Biomed Environ Sci 1997;10:316–26.

27. Neve J. Selenium as a risk factor for cardiovascular diseases. J Cardiovasc Risk 1996;3:42–7.

28. Collipp PJ, Chen SY. Cardiomyopathy and selenium deficiency in a two-year-old girl. N Engl J Med 1981;304:1304–5 [letter].

29. Raines DA, Kinsara AJ, Eid Fawzy M, et al. Plasma and urinary selenium in Saudi Arabian patients with dilated cardiomyopathy. Biol Trace Elem Res 1999;69:59–68.

30. Ikram H, Crozier IG, Webster M, Low CJ. The role of selenium deficiency in occidental dilated cardiomyopathy. N Z Med J 1989;102:100–2.

31. Chou HT, Yang HL, Tsou SS,et al. Status of trace elements in patients with idiopathic dilated cardiomyopathy in central Taiwan. Chung Hua I Hsueh Tsa Chih (Taipei) 1998;61:193–8.

32. Kittleson MD, Keene B, Pion PD, Loyer CG. Results of the multicenter spaniel trial (MUST): taurine- and carnitine-responsive dilated cardiomyopathy in American cocker spaniels with decreased plasma taurine concentration. J Vet Intern Med 1997;11:204–11.

33. Pion PD, Kittleson MD, Thomas WP, et al. Response of cats with dilated cardiomyopathy to taurine supplementation. J Am Vet Med Assoc 1992;201:275–84.

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