Chronic antioxidant administration restores macrovascular function in patients with heart failure with reduced ejection fraction.
Chronic antioxidant administration restores macrovascular function in patients with heart failure with reduced ejection fraction.
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DOI：
10.1113/ep088686
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发表时间：
2020-08
影响因子：
2.7
通讯作者：
Wray DW
中科院分区：
文献类型：
--
作者：
Bunsawat K;Ratchford SM;Alpenglow JK;Park SH;Jarrett CL;Stehlik J;Drakos SG;Richardson RS;Wray DW
心力衰竭伴射血分数降低（HFrEF）的特点是大血管功能障碍和氧化应激升高，可通过抗氧化剂（AOx）治疗减轻。在这项前瞻性研究中，我们评估了14名健康的老年对照参与者和14名HFrEF患者的血流介导扩张（FMD）和反应性充血反应，随后在患者组口服AOx （1 g维生素C， 600 iu维生素E和0.6 g α-硫辛酸）30天。还评估了氧化应激（丙二醛）和AOx能力（血浆铁还原能力）的血液生物标志物。HFrEF患者的FMD %（2.63±1.57%）低于对照组（5.62±2.60%），AOx改善了HFrEF患者的FMD %(30天，4.90±2.38%)，有效地恢复了对照组的大血管功能。在一组患者中，我们观察到在整个治疗期间，%FMD的进行性改善（分别为2.62±1.62、4.23±2.69、4.33±2.24和4.97±2.56%，分别为第0、10、20和30天，n = 12），在停止治疗7天后消失（2.99±1.78%,n = 9）。反应性充血在两组之间或AOx治疗后无明显差异。治疗后血浆铁还原能力增加（从6.08±2.80 mM到6.70±1.59 mM，第0天比第30天），丙二醛水平下降（从6.81±2.80 μM到6.22±2.84 μM，第0天比第30天）。这些研究结果表明，慢性给药AOx可以减轻HFrEF患者的氧化应激，提高AOx容量，恢复大血管功能。
Heart failure with reduced ejection fraction (HFrEF) is characterized by macrovascular dysfunction and elevated oxidative stress that may be mitigated by antioxidant (AOx) administration. In this prospective study, we assessed flow-mediated dilatation (FMD) and reactive hyperaemia responses in 14 healthy, older control participants and 14 patients with HFrEF, followed by 30 days of oral AOx administration (1 g vitamin C, 600 I.U. vitamin E and 0.6 g α-lipoic acid) in the patient group. Blood biomarkers of oxidative stress (malondialdehyde) and AOx capacity (ferric reducing ability of plasma) were also assessed. Patients with HFrEF had a lower %FMD (2.63 ± 1.57%) than control participants (5.62 ± 2.60%), and AOx administration improved %FMD in patients with HFrEF (30 days, 4.90 ± 2.38%), effectively restoring macrovascular function to that of control participants. In a subset of patients, we observed a progressive improvement in %FMD across the treatment period (2.62 ± 1.62,4.23 ± 2.69, 4.33 ± 2.24 and 4.97 ± 2.56% at days 0, 10, 20 and 30, respectively, n = 12) that was abolished 7 days after treatment cessation (2.99 ± 1.78%, n = 9). No difference in reactive hyperaemia was evident between groups or as a consequence of the AOx treatment. Ferric reducing ability of plasma levels increased (from 6.08 ± 2.80 to 6.70 ± 1.59 mM, day 0 versus 30) and malondialdehyde levels decreased (from 6.81 ± 2.80 to 6.22 ± 2.84 μM, day 0 versus 30) after treatment. These findings demonstrate the efficacy of chronic AOx administration in attenuating oxidative stress, improving AOx capacity and restoring macrovascular function in patients with HFrEF.