Abstract
BackgroundSome components of Nutraceuticals (NUT) such as red yeast rice and Morus alba have demonstrated positive effects on the endothelial function in hypercholesterolemic subjects. Our aim was to compare the effects of two different NUT combinations on cold pressure test (CPT) derived coronary flow reserve (CFR) assessed by transthoracic echo-Doppler.ResultsIn a randomized, single-blind study, 28 consecutive patients with a variety of cardiovascular risk factors received NUT A (LopiGLIK®: berberine, red yeast rice powder, and leaf extract of Morus alba) or B (Armolipid Plus®: policosanol, red yeast rice, berberine, astaxantine, folic acidandcoenzyme Q10). An echo-Doppler exam with evaluation of CFR was performed at baseline, 2 h (acute test) and 30 days after daily NUT assumption. Blood sampling for metabolic profile and platelet aggregometry was performed at baseline and after 30 days of daily NUT assumption. CFR was not significantly modified at the acute test. After 30 days, CFR improved with NUT A (p < 0.0001), because of the increase of hyperemic flow velocity (p = 0.007), but not with NUT B. CFR was comparable between the two groups at baseline but became significantly higher after 30 days in NUT A (p < 0.02), with a higher CFR percent variation versus baseline (p = 0.008). Total cholesterol and LDL-cholesterol were reduced with both NUT A (p < 0.001 and p < 0.002, respectively) and B (both p < 0.02), whereas platelet aggregation did not significantly change. In the pooled group of patients, after adjusting for age and percent changes of systolic blood pressure, heart rate, LDL-cholesterol and glycemia, NUT A – but not NUT B - was independently associated with CFR changes (β = 0.599, p = 0.003).ConclusionsLopiGLIK® improved endothelial-derived CFR, independently of the beneficial effects exerted on the lipid profile. These findings can have clinical reflections on the prevention of age-related inflammatory diseases including coronary artery disease.Trial registration(NUTRENDO)″(ClinicalTrials.gov, NCT02969070).
Highlights
Cardiac coronary system includes three different compartments, which are not well anatomically defined: a proximal compartment of epicardial coronary arteries, an intermediate compartment of pre-arterioles and a distal compartment of intramural arterioles, largely corresponding to coronary microcirculation [1]
Coronary system function can be tested by transthoracic Doppler echocardiography through the noninvasive assessment of coronary flow reserve (CFR), which is the maximal increase in coronary flow above its resting value for a given perfusion pressure [2]
The two groups were comparable for age, body mass index, diastolic Blood pressure (BP) and heart rate whereas systolic BP was significantly higher in NUT A (p = 0.034)
Summary
Cardiac coronary system includes three different compartments, which are not well anatomically defined: a proximal compartment of epicardial coronary arteries, an intermediate compartment of pre-arterioles and a distal compartment of intramural arterioles, largely corresponding to coronary microcirculation [1]. Coronary system function can be tested by transthoracic Doppler echocardiography through the noninvasive assessment of coronary flow reserve (CFR), which is the maximal increase in coronary flow above its resting value for a given perfusion pressure [2]. It is well recognized that, in absence of significant stenosis of the epicardial coronary arteries, CFR represents an accurate expression of coronary microvascular function. Hyperemia may even be provoked by a completely endothelium-dependent stimulus such as cold pressure test (CPT), which is performed by hand immersion in ice water for few minutes [2]. Our aim was to compare the effects of two different NUT combinations on cold pressure test (CPT) derived coronary flow reserve (CFR) assessed by transthoracic echo-Doppler
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