Motoyama T, Kawano H, Kugiyama K, Hirashima O, Ohgushi M, Tsunoda R, Moriyama Y, Miyao Y, Yoshimura M, Ogawa H, Yasue H
Division of Cardiology, Kumamoto University School of Medicine, Kumamoto City, Japan.
J Am Coll Cardiol. 1998 Nov 15;32(6):1672-9. doi: 10.1016/s0735-1097(98)00447-1.
We examined the effects of oral administration of vitamin E, an antioxidant, on endothelium-dependent vasodilation in patients with coronary spastic angina.
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.
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 (alpha-tocopherol acetate, 300 mg/day) or placebo, which is randomly assigned, in patients with CSA (n=60).
Before treatment, patients with CSA had impaired flow-dependent vasodilation, lower plasma levels of alpha-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; alpha-tocopherol levels: 8.9+/-1.8 vs. 10.8+/-1.8 microg/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.
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.
我们研究了口服抗氧化剂维生素E对冠状动脉痉挛性心绞痛患者内皮依赖性血管舒张功能的影响。
我们最近报道，冠状动脉痉挛性心绞痛（CSA）患者存在内皮依赖性血管舒张功能受损。此外，已知氧化应激可能在心血管疾病的内皮依赖性血管舒张功能受损中起重要作用。
采用超声技术，对60例CSA患者在随机给予口服维生素E（醋酸α-生育酚，300mg/天）或安慰剂治疗1个月前后，检测反应性充血期间肱动脉的血流依赖性血管舒张功能。
与年龄和性别匹配的对照组（n = 60）相比，CSA患者在治疗前存在血流依赖性血管舒张功能受损、血浆α-生育酚水平较低以及血浆硫代巴比妥酸反应物质（TBARS）水平较高（血流依赖性血管舒张功能：3.1±1.8% 对7.1±2.5%，p < 0.001；α-生育酚水平：8.9±1.8对10.8±1.8μg/ml，p < 0.001）。在CSA患者中，维生素E治疗可恢复血流依赖性血管舒张功能（3.1±1.7% 对8.3±2.0%，p < 0.001），且这种改善与血浆TBARS水平降低和心绞痛发作减少有关。
结果表明，维生素E治疗可改善CSA患者的内皮依赖性血管舒张功能并降低血浆TBARS水平。因此，氧化应激增加可能导致CSA患者的内皮功能障碍和心绞痛发作。
