title: Vascular function and the role of oxidative stress in heart failure, heart transplant, and beyond.
abstract: Using flow-mediated vasodilation (FMD), reactive hyperemia, and an acute oral antioxidant cocktail (AOC; vitamins C and E and α-lipoic acid), this study aimed to provide greater insight into altered vascular function and the role of oxidative stress in chronic heart failure patients with reduced ejection fraction (HFrEF) and at several time points beyond heart transplantation (HTx). A total of 61 age-matched subjects (12 healthy controls, 14 New York Heart Association class II and III HFrEF, and 35 HTx recipients [<3 years post-HTx, 5-10 years post-HTx, and >14 years post-HTx]) ingested either placebo (PL) or an AOC before FMD and reactive hyperemia testing of the brachial artery. Vascular function, as measured by FMD, was not different among the controls (6.8±1.9%), recent <3-year post-HTx group (8.1±1.2%), and the 5- to 10-year post-HTx group (5.5±1.0%). However, PL FMD was lower in the HFrEF (4.5±0.7%) and in the >14-year post-HTx group (2.9±0.8%). The AOC increased plasma ascorbate levels in all of the groups but only increased FMD in the controls (PL, 6.8±1.9%; AOC, 9.2±1.0%) and >14-year post-HTx recipients (PL, 2.9±0.8%; AOC, 4.5±1.3%). There were no differences in reactive hyperemia in any of the groups with PL or AOC. This cross-sectional study reveals that, compared with controls, vascular function is blunted in HFrEF, is similar soon after HTx, but is decreased with greater time post-HTx with free radicals implicated in this progression.
authors: Geriatric Research Education and Clinical Center, George E. Whalen VA Medical Center, Salt Lake City, UT, USA. melissa.witman@utah.edu
authors: Melissa A H
authors: MA
authors: Witman
authors: Anette S
authors: AS
authors: Fjeldstad
authors: John
authors: J
authors: McDaniel
authors: Stephen J
authors: SJ
authors: Ives
authors: Jia
authors: J
authors: Zhao
authors: Zachary
authors: Z
authors: Barrett-O'Keefe
authors: Jose N
authors: JN
authors: Nativi
authors: Josef
authors: J
authors: Stehlik
authors: D Walter
authors: DW
authors: Wray
authors: Russell S
authors: RS
authors: Richardson
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000494:pharmacology; D001205:Ascorbic Acid / Q000494:pharmacology; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D008063:Thioctic Acid / Q000494:pharmacology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014810:Vitamin E / Q000494:pharmacology
chemical_list: D000975:Antioxidants; D014810:Vitamin E; D008063:Thioctic Acid; D001205:Ascorbic Acid