Background: Heart failure (HF) is a complex clinical syndrome that can result from any structural or
functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood. It represents a major public
health issue, with a prevalence of over 23 million worldwide. The lifetime risk of developing HF is one in five
and the most important risk factors identified are ischemic heart disease, hypertension, smoking, obesity and
diabetes. Preventive approaches are based on improvements of lifestyle, associated with pharmacological therapy.
Several nutraceuticals have shown interesting clinical results in prevention of HF as well as in the treatment of the
early stages of the disease, alone or in association with pharmacological therapy.
Aim: The aim of this review is to resume the available clinical evidence on phytochemicals effect on HF prevention
Methods: A systematic search strategy was developed to identify trials in PubMed (January 1980 to April 2016).
The terms ‘nutraceuticals’, ‘dietary supplements’, ‘herbal drug’ and ‘heart failure’ were incorporated into an
electronic search strategy.
Results: Clinical trials reported that the intake of some nutraceuticals (hawthorn, coenzyme Q10, L-carnitine, Dribose,
Carnosine, Vitamin D, Some probiotics, Omega-3 PUFAs, Beet nitrates) is associated with improvements
in functional parameters such as ejection fraction, stroke volume and cardiac output in HF patients, with minimal
side effects. These findings were sometimes reinforced by subsequent meta-analyses, which further concluded
that benefits tended to be greater in earlier stage HF. The main mechanisms involved are antioxidant, antinflammatory,
anti-ischemic and antiaggregant effects.
Conclusions: Evidence suggests that the supplementation with nutraceuticals may be a useful option for effective
management of HF, with the advantage of excellent clinical tolerance.