Complementary Alternative Cardiovascular Medicine

106 Alternative Cardiovascular Medicine
TAURINE
Taurine is a conditionally essential sulfonic amino acid and found as
free and in small peptides forms. It is present in high amounts in the retina,
the brain, platelets, neutrophils, myocardium, skeletal, and smooth
muscles. Taurine is important in the development of normal central and
visual systems. Major dietary sources of taurine are animal food and seaweed,
with low levels found in plant foods. The metabolic effects of taurine
include modulation of intracellular calcium levels, detoxification,
membrane stabilization, and osmoregulation. It has antioxidant activity,
and some investigators believe it has hypocholesteremic, hypotensive,
antiatherogenic, and ionotropic properties.
Role in CVD
Taurine is abundantly present as a free amino acid in the myocardium.
Taurine-mediated increase in myocardial contractility is not mediated
via the cyclic adenosine monophosphate (cAMP). It modulates the activity
of low-voltage-dependent Ca2+ channels in addition to its effect on
other channels. This resulting increased intracellular calcium during the
action potential is believed to be the underlying mechanism for its
ionotropic properties. Taurine deficiency has been associated with cardiomyopathy,
and simple taurine replacement often leads to complete
recovery.
Azuma et al. (20) studied the effect of adding taurine to conventional
treatment in 14 patients with CHF in a double-blind, randomized, crossover,
and placebo-controlled study. The taurine group (n = 7) showed
marked improvement in New York Heart Association (NYHA) functional
class, pulmonary crackles, and chest film abnormalities (p < 0.02).
These results corresponded with reduction in preejection period index
on noninvasive testing, suggesting a positive ionotropic effect. In
another controlled study, Azuma et al. (21) demonstrated the beneficial
effect on the indexes of cardiac performance in 17 patients who
received taurine (3 g/d). There was no effect on the heart rate or blood
pressure. However, left ventricular systolic function improved (mean
EF from 39% to 47%, p < 0.01) and there was a significant increase in
stroke volume and cardiac output (p < 0.05). In a double-blind trial of
supplement or placebo, Jeejeebhoy et al. (22) reported a significant reduction
in the left ventricular end-diastolic volume (LVEDV), with a combined
supplement (containing taurine, CoQ10, and carnitine) in 41
patients with CHF (EF 40%). These studies suggest the need for an
appropriate clinical trial to define the role of taurine supplementation
in patients with CHF.