engleski

Supplementation of n-3 polyunsaturated fatty acids, selenium, vitamin E and lutein in a form of functional food improves flow mediated dilation of brachial artery in patients with chronic coronary artery disease

IntroductionCoronary artery disease (CAD), the most common type of heart disease and the leading cause of death in developed countries, is clinically manifested with established endothelial dysfunction (ED), which presents one of the earliest symptoms underlying various cardiovascular diseases (CVDs). It has been extensively reported that flow-mediated dilation (FMD) of the brachial artery in response to post- occlusive reactive hyperemia, assessed with ultrasounds, is impaired in patients with CAD, reflecting both local and systemic ED. Increased oxidative stress levels has been identified as akey pathophysiological mechanism mediating the development of ED. Thus, this study aimed to assess the effect of supplementation of cardiovascular protective and antioxidant nutrients (e.g. polyunsaturated fatty acids (n-3 PUFA), selenium, vitamin E and lutein) in a form of functional food on brachial artery FMD in patients with chronic stable CAD.MethodsThirty patients with diagnosed chronic stable CAD (9 women and 21 men) were instructed to eat three hard boiled hen eggs per day during study protocol that lasted for 21 days (total of 63 eggs). Subjects were divided in experimental NUTRI4 group (15 subjects) which consumed n-3 polyunsaturated fatty acids (n-3 PUFAs), selenium, vitamin E and lutein enriched hen eggs (1050 mg of n-3 PUFA/day, 0.06 mg of selenium/day, 3.29 mg of vitamin E/day, and 1.85 mg of lutein/per day), and in control group (15 subjects) which consumed regular hen eggs produced on the same farm (249 mg of n-3 PUFA per day, 0.05 mg of selenium/day, 1.79 mg of vitamin E/day, and 0.33 mg of lutein/per day). Brachial artery FMD (following 5-minute vascular occlusion) and nitroglycerin (NTG) dilation (following 400 mcg of NTG sublingual administration) were assessed using ultrasound and appropriate vascular probe (GE Healthcare Vivid iQ R2). Obtained images were analyzed by Brachial Analyzer for Research v.6 software (Medical Imaging Applications, USA).ResultsBrachial artery FMD significantly increased in NUTRI4 group following respective dietary intervention (FMD % of dilation before 6.84 ±3.60 vs. after 9.14 ± 4.79, P=0.015), while it remained unchanged in controls (FMD % of dilation before 9.67 ± 3.60 vs. after 9.89 ± 3.26, P=0.850). Brachial artery NTG dilation did not significantly change in both NUTRI4 (NTG % of dilation before 13.70 ±7.19 vs. after 12.38 ± 6.12, P=0.502) and Control group (NTG % of dilation before 14.42 ± 6.40 vs. after 14.46 ± 5.95, P=0.985) following respective dietary protocol.ConclusionSupplementation of n-3 PUFA, selenium, vitamin E and lutein in a form of functional food improves brachial artery FMD (endothelium dependent vasodilation), but not NTG dilation (endothelium-independent) in chronic CAD patients, potentially by providing more favorable lipid and antioxidant milieu.

functional food ; flow mediated dilation ; coronary artery disease

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