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As congestive heart failure advances, the body starts retaining fluid, especially in the lungs

Circulating 3-hydroxy butyrate predicts mortality in patients with chronic heart failure with reduced ejection fraction

L-Carnitine is known to increase fat-burning (fat oxidation) and energy levels in patients with conditions ranging from peripheral vascular disease to heart failure and kidney problems (6, 7, 8)

Without enough selenium, your body cannot turn the "spent" oxidized version back into the active "reduced" version

With the increase in enzyme activity, conversion of ammonia to glutamine should increase, thereby decreasing ammonia circulation and thus decreasing cerebral edema