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Double Blind Study Shows Melatonin Improves Endothelial Dysfunction

Out with the old, in with the new: may you be happy the whole year through. Happy New Year!

New Studies Adv Biomed Res.2016 Nov 28;5:174. doi: 10.4103/2277-9175.194801. eCollection 2016.

The effect of melatonin on endothelial dysfunction in patient undergoing coronary artery bypass grafting surgery.

Javanmard SH1, Heshmat-Ghahdarijani K1, Mirmohammad-Sadeghi M2, Sonbolestan SA1, Ziayi A3.


BACKGROUND: In this study, we investigated the effect of melatonin administration on four markers of endothelial cell function including intercellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), C-reactive protein (CRP), and nitric oxide (NO) on patients with three vessels coronary disease.

MATERIALS AND METHODS: This double-blind, randomized, controlled trial study was conducted on 39 patients (32 men and 7 women) with three vessels coronary disease. The case group included 20 patients who received 10 mg oral melatonin 1 h before sleeping for 1 month. The control group included 19 patients who received placebo 1 h before sleeping for 1 month. The serum levels of CRP, ICAM, VCAM, and NO were compared after 1 month treatment.

RESULTS: After 1 month of melatonin treatment, the mean level of ICAM, VCAM, and CRP showed a statistically significant decrease in the case group. On the other hand, the mean level of VCAM increased significantly in the control group. The mean levels of CRP and ICAM were also increased in the control group, but the difference did not reach the significant threshold. With respect to NO, there was a statistically significant increase in the case group, while there was a statistically significant decrease in serum NO in the control group.

CONCLUSIONS: The results of this study suggested that melatonin may have beneficial effects on endothelial oxidative stress even in patient with severe and advanced atherosclerosis.

Bottom Lines:

1) Endothelial dysfunction is at the core of atherosclerosis and its complications.

2) Start measuring your own and your patient’s endothelial function.

Echocardiography. 2016 Dec 29. doi: 10.1111/echo.13432. [Epub ahead of print]

Evaluation of the brachial artery endothelial function in chronic alcohol consumption among males by high-frequency ultrasonography.

Luo R1, Shen J1, Zhou Q1, Liu Y1, Li G1.


OBJECTIVE: There is evidence suggesting that different volumes of chronic alcohol consumption have different effects on the endothelium. Therefore, using high-frequency ultrasonography, we evaluate the effects of the different volume and duration of alcohol intake on brachial artery endothelial function in chronic drinkers.

METHODS: Ninety-two male chronic episodic alcoholics were grouped by alcohol intake amount and duration: mild (group B, n=30); ?90 mg ethanol daily, 3-5 days/wk for 5-8 years; moderate (group C, n=30); 90-150 mg ethanol daily, 3-5 days/wk for 9-20 years; and severe (group D, n=32); ?150 mg ethanol daily, 6-7 days/wk for more than 10 years. Thirty male nondrinkers were recruited as the control group A. High-frequency ultrasonography was used to measure brachial artery diameter during rest, during reactive hyperemia and following the administration of nitroglycerin. Endothelial-dependent brachial artery flow-mediated dilatation (FMD) and endothelial-independent brachial artery nitrate-mediated dilatation (NMD) were calculated.

RESULTS: Flow-mediated dilatation values for group C and D were significantly lower than those for group A and B (VC =7.63±0.22, VD=5.85±0.23 vs V A =13.35±0.35, VB =12.81±0.36, P .01). The FMD of group D was significantly lower than that of group C (P .01). Meanwhile, the NMD of group D was significantly lower than that of the other groups (VD =17.33±6.21 vs VA =25.35±7.42, VB =24.52±8.30, VC =23.35±7.27, P .01).

CONCLUSIONS: Chronic moderate-to-heavy alcohol consumption caused endothelial dysfunction, even damaging vascular smooth muscle cells in cases of heavy alcohol consumption, while abstinence and chronic mild alcoholics caused no effect on endothelial function.

Bottom Lines:

1) Use endothelial function monitoring as your guide to evaluate if alcohol is helping or hurting the cardiovascular system.

2) Start measuring your own and your patient’s endothelial function.

Int J Urol. 2016 Dec 29. doi: 10.1111/iju.13273. [Epub ahead of print]

Tadalafil for male lower urinary tract symptoms improves endothelial function.

Fukumoto K1, Nagai A1, Hara R1, Fujii T1, Miyaji Y1.


OBJECTIVES:To investigate the effects of tadalafil on vascular endothelial function and cardiovascular risk in patients with prostatic hyperplasia.

METHODS: Tadalafil 5 mg was given to 20 patients with prostatic hyperplasia for whom an α1-blocker was ineffective. Voiding symptoms and vascular endothelial function were investigated before and after 4 and 12 weeks of administration, using commercial tests for vascular function and vascular endothelial function.

RESULTS: The participants had a median age of 65 years, a mean body mass index of 24.2 and a mean prostate volume of 36.2 mL measured using transabdominal sonography. Voiding symptoms were significantly improved by tadalafil, based on the International Prostate Symptom Score, quality of life index and overactive bladder symptom score (P 0.05). There were also significant improvements in vascular function (change of brachial-ankle pulse wave velocity from 1701 [before] to 1657 [4 weeks tadalafil] and 1525 [10 weeks tadalafil] cm/s [P 0.05]) and vascular endothelial function (change of reactive hyperemia index from 1.36 to 1.56 and 1.89 [P 0.05]). The change in reactive hyperemia index was significantly correlated with International Prostate Symptom Score, quality of life index and brachial-ankle pulse wave velocity.

CONCLUSIONS: The improvement in intrapelvic blood flow by tadalafil can result in improved vascular endothelial function, in addition to improvement of voiding symptoms. The change in reactive hyperemia index seems to correlate with the severity of voiding symptoms, with tadalafil being most effective in patients with mild voiding symptoms.

Bottom Lines:

1) ED (Erectile dysfunction) and ED (Endothelial Dysfunction) go hand-in-hand.

2) Start measuring your own and your patient’s endothelial function.

New Indices of Endothelial Function Measured by Digital Thermal Monitoring of Vascular Reactivity Data from 6084 Patients Registry

Morteza Naghavi1 Albert A. Yen,2 Alex W. H. Lin,2 Hirofumi Tanaka,3 and Stanley Kleis4


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