Improvement of Endothelial Function With Dietary Flavanols Is Associated With Mobilization of Circulating Angiogenic Cells in Patients With Coronary Artery Disease
Improvement of Endothelial Function With Dietary Flavanols Is Associated With Mobilization of Circulating Angiogenic Cells in Patients With Coronary Artery Disease
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DOI：
10.1016/j.jacc.2010.03.039
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发表时间：
2010-07-13
影响因子：
24
通讯作者：
Yeghiazarians, Yerem
中科院分区：
文献类型：
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作者：
Heiss, Christian;Jahn, Sarah;Yeghiazarians, Yerem
在冠心病（CAD）患者中，我们测试了1个月含黄烷醇的可可饮食干预是否会改善内皮功能障碍，以及这是否与循环血管生成细胞（CACs）数量和功能的增强有关。背景：膳食黄烷醇可改善内皮功能障碍。CACs，也被称为内皮祖细胞，对血管修复和维持内皮功能至关重要。方法：在一项随机、对照、双盲、交叉试验中，16例冠心病患者（64 +/- 3岁）接受了高黄烷醇饮食干预（HiFI [375 mg]）和宏量营养素和微量营养素匹配的低黄烷醇干预（LoFI [9 mg]），每天两次，随机顺序，持续30天。结果：通过肱动脉血流介导的血管舒张来测量的内皮依赖性血管舒缩功能，在HiFI期间比LoFI期间改善了47%。HiFI后，流式细胞术检测CD34(+)/KDR+ CACs数量较LoFI后增加2.2倍。以生存、分化、增殖和迁移能力来衡量的CAC功能在两组之间没有差异。HiFI导致收缩压降低（LoFI平均变化：-4.2 +/- 2.7 mm Hg），血浆亚硝酸盐水平升高（LoFI平均变化：74 +/- 32 nM）。应用混合效应线性回归模型，结果显示随着CD34(+)/KDR+-CACs水平的升高，血流介导的血管舒张显著增加，收缩压显著降低。结论：定期饮食摄入黄烷醇对内皮功能障碍的持续改善与功能性cac的动员有关。可可黄烷醇对冠心病患者血管功能的影响：内皮祖细胞与微循环和大循环反应性的相互作用；NCT00553774)。[J]中华医学会心脏科杂志，2010;56:218-24 . [C] 2010
Objectives In patients with coronary artery disease (CAD) medically managed according to currently accepted guidelines, we tested whether a 1-month dietary intervention with flavanol-containing cocoa leads to an improvement of endothelial dysfunction and whether this is associated with an enhanced number and function of circulating angiogenic cells (CACs).Background Dietary flavanols can improve endothelial dysfunction. The CACs, also termed endothelial progenitor cells, are critical for vascular repair and maintenance of endothelial function.Methods In a randomized, controlled, double-masked, cross-over trial, 16 CAD patients (64 +/- 3 years of age) received a dietary high-flavanol intervention (HiFI [375 mg]) and a macronutrient- and micronutrient-matched low-flavanol intervention (LoFI [9 mg]) twice daily in random order over 30 days.Results Endothelium-dependent vasomotor function, as measured by flow-mediated vasodilation of the brachial artery, improved by 47% in the HiFI period compared with the LoFI period. After HiFI, the number of CD34(+)/KDR+ CACs, as measured by flow cytometry, increased 2.2-fold as compared with after LoFI. The CAC functions, as measured by the capacity to survive, differentiate, proliferate, and to migrate were not different between the groups. The HiFI led to a decrease in systolic blood pressure (mean change over LoFI: -4.2 +/- 2.7 mm Hg), and increase in plasma nitrite level (mean change over LoFI: 74 +/- 32 nM). Applying a mixed-effects linear regression model, the results demonstrated a significant increase in flow-mediated vasodilation and a decrease in systolic blood pressure with increasing levels of CD34(+)/KDR+-CACs.Conclusions Sustained improvements in endothelial dysfunction by regular dietary intake of flavanols are associated with mobilization of functional CACs. (Effect of Cocoa Flavanols on Vascular Function in Optimally Treated Coronary Artery Disease Patients: Interaction Between Endothelial Progenitor Cells, Reactivity of Micro-and Macrocirculation; NCT00553774). (J Am Coll Cardiol 2010; 56: 218-24) (C) 2010 by the American College of Cardiology Foundation