Different age-independent effects of nutraceutical combinations on endothelium-mediated coronary flow reserve

Roberta Esposito, Regina Sorrentino, Giuseppe Giugliano, Marisa Avvedimento, Roberta Paolillo, Ciro Santoro, Maria Scalamogna, Mafalda Esposito, Federica Ilardi, Francesco Rozza, Giovanni Esposito, Maurizio Galderisi, Valentina Trimarco, Roberta Esposito, Regina Sorrentino, Giuseppe Giugliano, Marisa Avvedimento, Roberta Paolillo, Ciro Santoro, Maria Scalamogna, Mafalda Esposito, Federica Ilardi, Francesco Rozza, Giovanni Esposito, Maurizio Galderisi, Valentina Trimarco

Abstract

Background: Some 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.

Results: In 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).

Conclusions: LopiGLIK® 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).

Keywords: Cholesterol-lowering; Cold pressure test; Coronary flow reserve; Endothelial function; Nutraceutical therapy.

Conflict of interest statement

Ethics approval and consent to participate obtained (Ethics Committee of University of Naples Federico II, #258/16).Consent for publication obtained by all the authors.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Beneficial effect of NUT A combination on CPT-derived CFR after 30 days therapy. Time 0 CFR (upper panel): baseline (left) and post CPT (right) coronary flow velocities; Combination A Time 2 CFR (lower panel): baseline (left) and post CPT (right) coronary flow velocities. CFR = Coronary flow reserve. CPT = Cold pressure test
Fig. 2
Fig. 2
Comparison of baseline and 30 days CFR, and CFR percent changes (30 days versus baseline) in NUT A and NUT B patients

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