Association of blood essential and non-essential element levels with echocardiographic parameters among Saudi heart failure patients: a case-control study

Background: Essential elements such as manganese (Mn), iron (Fe), and zinc (Zn) are critical in for cardiovascular function, whereas exposure to non-essential toxic metals, including cadmium (Cd) and chromium (Cr) may contribute to cardiac dysfunction and the development or progression of heart failure (HF). Aim: This study evaluated the blood levels of Mn, Fe, Zn, Cd, and Cr in adult Saudi patients with HF and in controls with normal ventricular function, and explored their associations with HF status, functional class, and echocardiographic parameters. Methods: Consecutive adult patients referred for clinically indicated transthoracic echocardiography at the outpatient department of King Fahad Medical City hospital between November 2019 and March 2020 were invited to participate. Clinical data were collected, echocardiograms were reviewed, and blood concentrations of of Mn, Fe, Zn, Cd, and Cr were measured using atomic absorption spectrophotometry. Result: = 0.099). Conclusion: This study provides insight into Mn, Fe, Zn, Cd, and Cr concentrations across a spectrum of HF severity. Alteration in Cd and Mn blood levels were associated with selected echocardiographic markers of HF severity. Further longitudinal studies are needed to establish the prognostic significance of element imbalances in HF.