Vitamin E administration improves impairment of endothelium-dependent vasodilation in patients with coronary spastic angina

• Published in: Journal of the American College of Cardiology 1998-11, Vol.32 (6), p.1672-1679
• Main Authors: Motoyama, Takeshi, Kawano, Hiroaki, Kugiyama, Kiyotaka, Hirashima, Osamu, Ohgushi, Masamichi, Tsunoda, Ryusuke, Moriyama, Yasushi, Miyao, Yuji, Yoshimura, Michihiro, Ogawa, Hisao, Yasue, Hirofumi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angina Pectoris, Variant - drug therapy; Angina Pectoris, Variant - etiology; Angina Pectoris, Variant - physiopathology; Arteries - physiopathology; Biological and medical sciences; Brachial Artery - physiopathology; Coronary Vasospasm - complications; Coronary Vessels - physiopathology; Endothelium, Vascular - physiopathology; Female; General and cellular metabolism. Vitamins; Hemodynamics - physiology; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Regional Blood Flow - physiology; Smoking; Thiobarbituric Acid Reactive Substances - analysis; Vasodilation - drug effects; Vasodilation - physiology; Vitamin E - blood; Vitamin E - therapeutic use
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(98)00447-1

Objectives. We examined the effects of oral administration of vitamin E, an antioxidant, on endothelium-dependent vasodilation in patients with coronary spastic angina. Background. We have recently reported that endothelium-dependent vasodilation is impaired in patients with coronary spastic angina (CSA). Furthermore, it is known that oxidative stress may play an important role in the impairment of endothelium-dependent vasodilation in cardiovascular diseases. Methods. With the ultrasound technique, flow-dependent vasodilation of the brachial arteries during reactive hyperemia was examined before and after treatment for a month with either oral administration of vitamin E (α-tocopherol acetate, 300 mg/day) or placebo, which is randomly assigned, in patients with CSA (n = 60). Results. Before treatment, patients with CSA had impaired flow-dependent vasodilation, lower plasma levels of α-tocopherol and higher plasma levels of thiobarbituric acid reactive substances (TBARS), as compared with age- and sex-matched control subjects (n = 60) (flow-dependent vasodilation: 3.1 ± 1.8 vs. 7.1 ± 2.5%, p < 0.001; α-tocopherol levels: 8.9 ± 1.8 vs. 10.8 ± 1.8 μg/ml, p < 0.001). In patients with CSA, treatment with vitamin E restored flow-dependent vasodilation (3.1 ± 1.7 vs. 8.3 ± 2.0%, p < 0.001), and this improvement was associated with the decreases in plasma TBARS levels and anginal attacks. Conclusions. The results indicate that vitamin E treatment improved endothelium-dependent vasodilation and decreased plasma TBARS levels in patients with CSA. Thus, increased oxidative stress may contribute to endothelial dysfunction and anginal attacks in patients with CSA.