Taurine is a sulfur-containing amino acid that is one of the most important cardiomyocyte protectors in the human body — it is the most abundant free amino acid in the heart muscle (at concentrations of 15-40 µmol/g), where it exerts its protective effects through multiple mechanisms including the osmoregulation, the calcium homeostasis, the antioxidant defence, and the modulation of the GABA and the glycine receptor activity. The taurine in the cardiomyocytes acts as an osmolyte that regulates the cell volume in response to the osmotic stress (particularly during the ischaemia-reperfusion injury), as a calcium stabiliser that modulates the calcium influx through the L-type calcium channels and the calcium release from the sarcoplasmic reticulum, as an antioxidant that scavenges the hypochlorous acid and the superoxide radicals that are generated during the oxidative stress, and as a direct membrane stabiliser that protects the cardiomyocyte membrane from the ischaemic damage. The deficiency of the taurine in the heart muscle leads to the disrupted calcium homeostasis, the increased oxidative stress, the membrane instability, and the impaired contractility that are the primary causes of the arrhythmias, the cardiomyopathy, and the sudden cardiac death that are associated with the severe taurine deficiency. The normal plasma taurine level is approximately 40-120 µmol/L, and the erythrocyte taurine level is approximately 200-400 µmol/L — levels below these ranges indicate the taurine deficiency that may contribute to the cardiac dysfunction and the arrhythmia susceptibility.
Taurine and the Arrhythmia Prevention
Taurine supports the arrhythmia prevention primarily through its calcium stabilising and membrane-protective effects in the cardiomyocytes — the taurine modulates the L-type calcium channel activity and the calcium handling by the sarcoplasmic reticulum, thereby reducing the propensity for the delayed afterdepolarisations (DADs) and the early afterdepolarisations (EADs) that are the primary triggers of the re-entrant arrhythmias. The taurine also stabilises the cardiomyocyte membrane by increasing the phosphatidylinositol content and by reducing the lipid peroxidation, which protects the membrane from the ischaemic damage that is a major trigger of the lethal arrhythmias during the myocardial infarction. The combination of the calcium stabilisation and the membrane protection makes the taurine one of the most effective and most specific cardioprotective agents for the prevention of the ischaemia-induced ventricular arrhythmias, and it explains why the taurine supplementation has been consistently shown to reduce the ventricular arrhythmia burden in both the animal models and the human clinical trials.
The clinical importance of the taurine for the cardiac health is underscored by the observation that the taurine supplementation improves the cardiac function and reduces the arrhythmia burden in people with heart failure and with the cardiomyopathy. A meta-analysis of 7 RCTs in over 400 patients with heart failure found that the taurine supplementation at 1.5-3g daily significantly improved the left ventricular ejection fraction (LVEF) (by 3-5 absolute percentage points), reduced the plasma BNP levels (by 20-30%), and reduced the ventricular arrhythmia burden (by 30-40%) — demonstrating the potent and clinically meaningful cardioprotective effect of the taurine in heart failure patients.
Practical Application
For general taurine support for the cardiac health, the evidence-based approach is to supplement with the taurine at 1.5-3g daily (as the pure taurine powder or capsules, taken in divided doses of 500mg-1g). The taurine should be taken with the food for the best absorption and for the minimisation of the gastrointestinal side effects. The taurine is generally well-tolerated with no significant adverse effects at the doses that are used for the cardiac protection (up to 6g daily), though some people may experience mild gastrointestinal discomfort or the headache at the higher doses. For comprehensive taurine support and cardiac protection, taurine pairs well with the magnesium (which is a natural calcium channel blocker that works synergistically with the taurine for the cardiac electrical stability — the combination of the taurine and the magnesium is one of the most effective and most evidence-based combinations for the prevention of the arrhythmias and for the protection of the cardiac function, and it is particularly useful for people with the cardiomyopathy or with the history of the ventricular arrhythmias), with the coenzyme Q10 (which is a mitochondrial antioxidant that supports the cardiac energy production and which works synergistically with the taurine for the cardioprotection — the combination of the taurine and the CoQ10 is one of the most effective combinations for the heart failure management and for the protection of the cardiac function, and it is particularly useful for people with the chronic heart failure or with the ischaemic heart disease), and with the omega-3 fatty acids (which have complementary anti-inflammatory and membrane-stabilising effects on the cardiovascular system — the combination of the taurine and the omega-3 fatty acids is one of the most effective combinations for the comprehensive cardiovascular protection and for the reduction of the cardiovascular disease risk).
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