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The impact of flavonoid supplementation on acute smoking-induced vascular dysfunction and fibrinolytic impairment

Session Clinical impact and modulation of endothelial (dys)function

Speaker Evangelos Oikonomou

Event : ESC Congress 2015

  • Topic : basic science
  • Sub-topic : Basic Science - Vascular Biology and Physiology
  • Session type : Moderated Posters

Authors : E Kokkou (Athens,GR), G Siasos (Athens,GR), E Oikonomou (Athens,GR), A Verveniotis (Athens,GR), N Gouliopoulos (Athens,GR), K Zisimos (Athens,GR), M Zaromytidou (Athens,GR), A Miliou (Athens,GR), K Mourouzis (Athens,GR), D Tousoulis (Athens,GR)

E. Kokkou1 , G. Siasos1 , E. Oikonomou1 , A. Verveniotis1 , N. Gouliopoulos1 , K. Zisimos1 , M. Zaromytidou1 , A. Miliou1 , K. Mourouzis1 , D. Tousoulis1 , 1University of Athens Medical School, 1st Cardiology Department, “Hippokration” Hospital - Athens - Greece ,

European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 177-178

Background: Smoking is associated with vascular dysfunction and impairment of fibrinolytic status. Concord grape juice (CGJ), a rich source of flavonoids, can modify cardiovascular risk factors. Endothelial function and arterial stiffness are surrogate markers of arterial health.

Purpose: To evaluate the impact of CGJ on endothelial function, arterial stiffness and fibrinolytic status in healthy smokers.

Methods: We studied the effect of a 2 weeks oral treatment with CGJ in 26 healthy smokers on three occasions (day 0: baseline, day 7 and day 14) in a randomized, placebo-controlled, double-blind, cross-over design. Measurements were carried out before (pSm), immediately (Sm0) and 20 minutes after (Sm20) cigarette smoking. Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery. Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness. Serum levels of plasminogen activator inhibitor 1 (PAI-1) were measured at each study day immediately before smoking and 20 minutes later as a biomarker of fibrinolytic status.

Results: Treatment with CGJ resulted in a significant improvement in FMD (from 8.35±2.83% day 0 to 9.15±4.21% day 7 to 9.49±2.74% day 14, p=0.02) and PWV (from 6.13±0.61m/sec day 0 to 5.86±0.63m/sec day 7 to 5.63±0.56m/sec day 14, p=0.04). Treatment with placebo had no impact on FMD values (p=NS) and PWV (p=NS). Compared to placebo, CGJ treatment prevented the acute smoking induced decrease in FMD in day 7 (p=0.07) and in day 14 (p=0.04). Treatment with CGJ prevented the smoking induced elevation of PWV, after 7 (p=0.055) and 14 (p=0.04) days of treatment. Smoking induced an elevation in PAI-1 levels after smoking compared to pro-smoking levels in all study days and in both arms (CGJ and placebo) of the study (p<0.05, for all). Importantly, treatment with CGJ decreased pSm values of PAI-1 [from 102 (65–134)ng/ml day 0 to 58 (42–75)ng/ml day 7 to 0.39 (20–47)ng/ml day 14, p<0.001] while placebo had no impact on PAI-1 levels (p=0.2). Moreover CGJ significantly ameliorated the acute smoking induced increase in PAI-1 levels [from 24 (13–55)ng/ml day 0 to 14 (7–31)ng/ml day 7 to 13 (7–23)ng/ml day 14, p<0.001] while placebo had no impact on the acute smoking induced increase in PAI-1 levels (p=0.17).

Conclusions: Concord grape juice consumption improved endothelial function and vascular elastic properties of the arterial tree during the acute phase of smoking, an effect accompanied by improvement in the fibrinolytic status of the subjects. These findings shed further light on the favorable mechanisms of Concord grape juice in atherosclerosis.

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