Parenteral Nutrition and Cardiotoxicity

Cardiovasc Toxicol. 2021 Apr;21(4):265-271. doi: 10.1007/s12012-021-09638-1. Epub 2021 Feb 7.

Abstract

Parenteral nutrition (PN) is a life-saving nutritional therapy for those situations when patients are unable to receive enteral nutrition. However, despite a multitude of benefits offered by PN, it is associated with a variety of side effects, most notably parenteral nutrition-associated liver disease (PNALD). Adverse effects of PN on other organ systems, such as brain and cardiovascular system, have been poorly studied. There have been several case reports, studies, and a recent animal study highlighting cardiotoxic effects of PN; however, much remains unclear about the underlying mechanisms causing cardiac damage. In this review, we propose a series of potential mechanisms behind PN-associated heart injury, and we provide an overview of therapeutic strategies and recent scientific advances.

Keywords: Endothelial nitric oxide synthase; Parenteral nutrition; Reactive oxygen species; Tetrahydrobiopterin.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antioxidants / therapeutic use
  • Biopterins / analogs & derivatives
  • Biopterins / therapeutic use
  • Cardiotoxicity
  • Heart Diseases / drug therapy
  • Heart Diseases / etiology*
  • Heart Diseases / metabolism
  • Heart Diseases / physiopathology
  • Humans
  • Oxidative Stress* / drug effects
  • Parenteral Nutrition / adverse effects*
  • Reactive Oxygen Species / metabolism*
  • Receptors, G-Protein-Coupled / agonists
  • Receptors, G-Protein-Coupled / metabolism*
  • Signal Transduction

Substances

  • Antioxidants
  • GPBAR1 protein, human
  • Reactive Oxygen Species
  • Receptors, G-Protein-Coupled
  • Biopterins
  • sapropterin