Feasibility and Effectiveness of Micronutrients as Palliative Care Therapy in Patients With Congestive Heart Failure

• Change in Quality of Life between baseline and six months [ Time Frame: Change in Quality of Life between baseline and six months ] [ Designated as safety issue: No ]
  The Minnesota Living with Heart Failure Questionnaire will be used to assess quality of life at baseline, 3 months and 6 months
• Change in nutritional status between baseline and six months [ Time Frame: Change in nutritional status between baseline and six months ] [ Designated as safety issue: No ]
  Nutritional status will be determined using the Nine-Step Nutritional Care Process as developed by Dr. Mary Ann Kight. Axes of evidence to determine nutritional stutus include weight / anthropometrics, dietary/ alimentation, biochemical, clinical and drug.

The purpose of this project is to conduct a preliminary test of the feasibility of a multi-micronutrient intervention to improve micronutrient status, cardiac function and quality of life in Veterans with Congestive Heart Failure (CHF).

• Congestive Heart Failure
• Ischemic Cardiomyopathy

Inclusion Criteria:

• stable congestive heart failure (CHF) (three months without an exacerbation or major change in medication regimen) Stage B, C or D CHF resulting from ischemic cardiomyopathy with an ejection fraction ≤ 45%.

Exclusion Criteria:

• recent (within the last three months) acute myocardial infarction or unstable angina, pacemaker or defibrillator or anticipated pacemaker or defibrillator placement in the next six months, ferro magnetic materials (i.e., penile stimulator), inability to lie flat for up to one hour, inability to hold their breath for up to 15 seconds, corticosteroid use (> 20 mg Prednisone use or its equivalent per day > 2 weeks duration), isoniazid therapy, use of the study nutrition supplements at the study doses for the past month or longer,(if the participant has been taking a multivitamin or multivitamin with minerals , or other water soluble vitamins they will need to stop taking these for at least one month prior to initiating the study intervention), end-stage liver disease, end-stage renal disease requiring dialysis, receiving chemotherapy or radiation therapy, active alcohol/ substance abuse, pregnancy /lactation, women of childbearing potential who do not have medical documentation of surgically induced menopause, pancreatitis, any psychological issues like severe depression, claustrophobia, active problematic Post Traumatic Stress Disorder (PTSD), or memory loss that prevents compliance with the supplement intake, agoraphobia which may interfere attendance at research visits or fear of needles which would limit their ability to have the blood tests completed, and any active eating disorders.