66) Therapies include medications lowering heart rate, cardioversion or radiofrequency ablation of arrhythmias, and antiarrhythmic surgery.63) Even though LV function normalizes rapidly with treatment, recurrent tachycardia can cause rapid decline in LV function, development

of heart failure and sudden cardiac death.65) Deficiencies Deficiencies of nutrients, electrolytes or trace elements can cause LV systolic dysfunction. Sometimes these Bortezomib patients exhibit other symptoms of deficiencies, i.e., patients with hypophosphatemia show skeletal muscle weakness.67) These deficiencies are usually associated with malnutrition, intoxication or misuse of illegal drugs. Correction of these Inhibitors,research,lifescience,medical deficiencies can improve LV systolic function with time. Thiamine deficiency Thiamine is a coenzyme that assists in macronutrient oxidation and the production of cellular adenosine till triphosphate.68) Because thiamine is a water soluble B-complex vitamin, thiamine deficiency is usually caused by malnutrition and/or excess diuretic use.68),69) One study Inhibitors,research,lifescience,medical reported thiamine deficiency in about one-third of patients with congestive heart failure.69) Thiamine deficiency is characterized by peripheral vasodilatation,69) and in addition to LV dilatation and dysfunction, these patients may have RV dysfunction with severe pulmonary hypertension.70) The presence Inhibitors,research,lifescience,medical of skeletal muscle edema in patients with

thiamine deficiency induced myopathy can be identified with T2-weighted imaging on magnetic resonance imaging,71) suggesting Inhibitors,research,lifescience,medical the same process may be used to identify myocardial edema in patients with thiamine deficiency and LV dysfunction. With thiamine replacement, the improvement is dramatic and rapid.68),70) Hypophosphatemia Transient Inhibitors,research,lifescience,medical LV systolic dysfunction can occur as a consequence of chronic ingestion

of large quantities of a phosphate, for example as antacid.67) Hypophosphatemia may cause diffuse LV dilatation and dysfunction as well as profound skeletal muscle weakness. After restoration of the serum phosphorus level, LV systolic dysfunction usually normalizes within 2 to 5 weeks.67) Hypocalcemia and hypoparathyroidism Reversible LV systolic dysfunction can be associated with hypocalcemia and hypoparathyroidism.72) The resultant hypocalcemia Batimastat and hypomagnesemia are possible mechanisms of LV systolic dysfunction.72) Carnitine deficiency A small percentage of dilated cardiomyopathy and hypertrophic cardiomyopathy cases result from carnitine deficiency,73) and dietary supplement of L-carnitine improves mortality, especially in children.74) Selenium deficiency Selenium, an essential trace element, is a component of glutathione peroxidase and may prevent oxidative damage to cells. Selenium deficiency has been noted to cause dilated cardiomyopathy, especially in children with poor nutrition.