Effect of Green Tea on Endothelial Function Assessed by the Flow Mediated Dilatation among Coronary Artery Disease Patients
Abstract
Background. Endothelial dysfunction begins when atherosclerosis developed as what go through on hypertension, diabetes, hyper-homocysteinemia, and also what go through among smoker who hasn’t have CAD until end phase of atherosclerosis. Impairment of endothelial function depends on vasodilatation due to the decreasing of eNOS activity. Green tea has been proved to have positive effect in reversing endothelial dysfunction among healthy smoker. This study aim to prove that the short term green tea consumption improved flow mediated dilatation among coronary artery disease patients, thus reversed endothelial dysfunction.Methods and results.Twenty three coronary artery disease patients which had been confirmed by coronary angiography joined the study. The sample was divided into two groups, first was the group who took green tea, and the second was the group who took placebo (mineral water). Before treatment, the FMD of both two groups were measured and one hour and half after treatment. After 3-7 days of treatment, both groups were crossover. FMD among healthy group of age less than 25 years old was also measured as control group. There was no significant differences in baseline characteristic between the first and the second group (both received green tea but in different time). FMD after treatment was increased among group who took green tea (4.80±5.37 vs 8.68±6.00, p=0.026), while FMD among placebo group was decreased (5.87±3.89 vs 3.34±3.66 p=0.026). There was significant differences of FMD after treatment with green tea and after treatment with placebo (8.68±6.00 vs 3.35±3.66 p = 0.002). There was no differences of brachial artery diameter in both groups (4.60±0.36 vs 4.57±0.41, p=0.8 and 4.57±0.41 vs 4.61±0.36, p=0.601). There was no significant differences on systolic and diastolic blood pressure as well as heart rate in both groups.
Conclusions. Green tea had positive effect in reversing endothelial dysfunction among coronary artery disease patient by assessing flow mediated dilatation in short time. The group who took placebo showed the paradoxical effect.
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References
Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation, 2004; 109 [suppl III]: 27 -32
Vallance P, Chan N. Endothelial function and nitric oxide : clinical relevance. Heart Journal. 2001;85:342-350.
Jadhav UM, Sivaramakrishnan A, Kadam NN. Non invasive Assesment of endothelial dysfunction by brachial artery flow mediated dilatation in prediction of coronary artery disease in Indian subjects. Indian Heart J 2003;55: 44-48.
Wood M.J, Steward R.L, Merry H, Johnstone D.E, Cox J.L. Use of complementary and alternative therapies in patients with cardiovascular disease. Am Heart Journal. 2003; 145: 806-12.
Purnawan I, pengaruh pemberian teh hijau terhadap plak atherosclerosis aorta kelinci yang diberi diit aterogenik, Tesis program PPDS I departemen Kardiologi dan Kedokteran Vaskular fakultas Kedokteran Universitas Indonesia 2003.
Nagaya N, Yamamoto H, Uematsu M, Itoh T, Nakagawa K, Miyazawa T, et al. Green tea reverse endothelial dysfunc-tion in healthy smokers. Heart 2004; 90: 1485-1486.
Duffy S.J, Keaney J.F, Holbrook M, Gokce N, Swerdloff P.L, Frei B, et al. Short- and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease. Circulation, 2001; 104:151-156.
Leeson P, Thorne S, Donald A, Mullen M, Clarkson P, Deanfield J. Non invasive measurement of endothelial function: effect on brachial artery dilatation of graded endothelial dependent and independent stimuli. Heart Journal 1997; 78: 22-27.
Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilatation of the brachial artery: a report of the international brachial artery reactivity task forces. J Am Coll Cardiol 2002;39:257-65.
Varin R, Mulder P, Tamion F, Richard V, Henry J.P, Lallemand F, et al.Improvement of Endothelial Function by Chronic Angiotensin-Converting Enzyme Inhibition in Heart Failure. Circulation. 2000;102:351-356.
Anderson T.J, Meredith I, Yeung A.C, Balzfrei, Selwyn A.P, Ganz P. The effect of cholesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med 1995;332:488-93.
Benjamin E.J, Larson M.G, Keyes M.J, Mitchell G.F, Vasan R.S, Keaney J.F, et al. Clinical Correlates and Heritability of flow mediated dilatation in the community (The Framingham Heart Study). Circulation. 2004; 109:613-619.
Husain S, Andrews N.P, Mulcahy D, Panza J.A, Quyyumi A.A. Aspirin Improves Endothelial Dysfunction in Atherosclerosis. Circulation1998;97:716-720.
Al Suwaidi J, Hamasaki S, Higano ST, Nishimura RA, Holmes DR, Lerman A. Long-Term Follow-Up of Patients With Mild Coronary Artery Disease and Endothelial Dysfunction. Circulation 2000;101:948-954.
Schächinger V, Britten MB, Zeiher A.M. Prognostic Impact of coronary vasodilator dysfunction on adverse long term outcome of coronary heart disease. Circulation, 2000; 101: 1899-1906.
Lorenz M, Wessler S, Follman E, Michaelis W, Dusterhoft T, Baumann G, et.al. A Constituent of green tea, Epigallocatechin-3-gallate, activates Endotehelial Nitric Oxide Synthase by a Phosphatidylinositol-3-OH-kinase, cAMP-dependent Protein Kinase, and Akt-dependent pathway and leads to Endothelial dependent vasorelaxation. The Journal Of Biological Chemistry, 2004; 279 (7):6190-6195.
Riemersma R.A, Rice-Evans C.A, Tyrell R.M, Clifford M.N, Lean M.E.J. Tea flavonoids and Cardiovascular Health. Q J Med 2001; 94: 277-282.
Tedeschi E, Menegazzi M, Yao Y, et.al. Green Tea Inhibits Human Inducible Nitric-Oxide Synthase Expression by Down-Regulating Signal Transducer and Activator of Transcription-1 Activation. Moll Pharmacol 2004 ; 65 : 111-120.
Vita Joseph A. Tea Consumption and Cardiovascular Disease: Effects on Endothelial Function. J Nutr 2003.133:3293S-3297S.
Plotnick G.D, Corretti M.C, Vogel R.A, Hesslink R, Wise J.A. Effect of Supplemental Phytonutrients on Impairment of the Flow-Mediated Brachial Artery Vasoactivity After a Single High-Fat Meal. J Am Coll Cardiol 2003;41:1744–9
Diaz MN, Frei Balz, Vita J.A, Keaney J.F. Antioxidant and atherosclerotic heart disease. New England Journal Of Medicine, 1997; 337: 408-416.
Mc Kay DL, Blumberg JB. Review of the role of tea in human health: an update. Journal of the American College of Nutrition 2002;21:1-22.
Lee Mao-jung, Malaikal P, Chen L, Meng X, Bondoc F.Y, Prabhu S, et al. Pharmacokinetic of tea catechins after ingestion of green tea and (-)-Epigallocatechin-3-gallate by humans: Formation of different metabolites and individual variability. Cancer Epidemiology, Biomarker & prevention 2002; 11: 1025-1032.
Tousoulis D, Antoniades C, Stefanadis C. Evaluating endothelial function in humans: a guide to invasive and non invasive techniques. Heart 2005;91:553-558.
Ross R. Atherosclerosis-An Inflamatory Disease. New England Journal of Medicine. 1999; 340: 115-126.
Vallance P, Chan N. Endothelial function and nitric oxide : clinical relevance. Heart Journal. 2001;85:342-350.
Jadhav UM, Sivaramakrishnan A, Kadam NN. Non invasive Assesment of endothelial dysfunction by brachial artery flow mediated dilatation in prediction of coronary artery disease in Indian subjects. Indian Heart J 2003;55: 44-48.
Wood M.J, Steward R.L, Merry H, Johnstone D.E, Cox J.L. Use of complementary and alternative therapies in patients with cardiovascular disease. Am Heart Journal. 2003; 145: 806-12.
Purnawan I, pengaruh pemberian teh hijau terhadap plak atherosclerosis aorta kelinci yang diberi diit aterogenik, Tesis program PPDS I departemen Kardiologi dan Kedokteran Vaskular fakultas Kedokteran Universitas Indonesia 2003.
Nagaya N, Yamamoto H, Uematsu M, Itoh T, Nakagawa K, Miyazawa T, et al. Green tea reverse endothelial dysfunc-tion in healthy smokers. Heart 2004; 90: 1485-1486.
Duffy S.J, Keaney J.F, Holbrook M, Gokce N, Swerdloff P.L, Frei B, et al. Short- and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease. Circulation, 2001; 104:151-156.
Leeson P, Thorne S, Donald A, Mullen M, Clarkson P, Deanfield J. Non invasive measurement of endothelial function: effect on brachial artery dilatation of graded endothelial dependent and independent stimuli. Heart Journal 1997; 78: 22-27.
Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilatation of the brachial artery: a report of the international brachial artery reactivity task forces. J Am Coll Cardiol 2002;39:257-65.
Varin R, Mulder P, Tamion F, Richard V, Henry J.P, Lallemand F, et al.Improvement of Endothelial Function by Chronic Angiotensin-Converting Enzyme Inhibition in Heart Failure. Circulation. 2000;102:351-356.
Anderson T.J, Meredith I, Yeung A.C, Balzfrei, Selwyn A.P, Ganz P. The effect of cholesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med 1995;332:488-93.
Benjamin E.J, Larson M.G, Keyes M.J, Mitchell G.F, Vasan R.S, Keaney J.F, et al. Clinical Correlates and Heritability of flow mediated dilatation in the community (The Framingham Heart Study). Circulation. 2004; 109:613-619.
Husain S, Andrews N.P, Mulcahy D, Panza J.A, Quyyumi A.A. Aspirin Improves Endothelial Dysfunction in Atherosclerosis. Circulation1998;97:716-720.
Al Suwaidi J, Hamasaki S, Higano ST, Nishimura RA, Holmes DR, Lerman A. Long-Term Follow-Up of Patients With Mild Coronary Artery Disease and Endothelial Dysfunction. Circulation 2000;101:948-954.
Schächinger V, Britten MB, Zeiher A.M. Prognostic Impact of coronary vasodilator dysfunction on adverse long term outcome of coronary heart disease. Circulation, 2000; 101: 1899-1906.
Lorenz M, Wessler S, Follman E, Michaelis W, Dusterhoft T, Baumann G, et.al. A Constituent of green tea, Epigallocatechin-3-gallate, activates Endotehelial Nitric Oxide Synthase by a Phosphatidylinositol-3-OH-kinase, cAMP-dependent Protein Kinase, and Akt-dependent pathway and leads to Endothelial dependent vasorelaxation. The Journal Of Biological Chemistry, 2004; 279 (7):6190-6195.
Riemersma R.A, Rice-Evans C.A, Tyrell R.M, Clifford M.N, Lean M.E.J. Tea flavonoids and Cardiovascular Health. Q J Med 2001; 94: 277-282.
Tedeschi E, Menegazzi M, Yao Y, et.al. Green Tea Inhibits Human Inducible Nitric-Oxide Synthase Expression by Down-Regulating Signal Transducer and Activator of Transcription-1 Activation. Moll Pharmacol 2004 ; 65 : 111-120.
Vita Joseph A. Tea Consumption and Cardiovascular Disease: Effects on Endothelial Function. J Nutr 2003.133:3293S-3297S.
Plotnick G.D, Corretti M.C, Vogel R.A, Hesslink R, Wise J.A. Effect of Supplemental Phytonutrients on Impairment of the Flow-Mediated Brachial Artery Vasoactivity After a Single High-Fat Meal. J Am Coll Cardiol 2003;41:1744–9
Diaz MN, Frei Balz, Vita J.A, Keaney J.F. Antioxidant and atherosclerotic heart disease. New England Journal Of Medicine, 1997; 337: 408-416.
Mc Kay DL, Blumberg JB. Review of the role of tea in human health: an update. Journal of the American College of Nutrition 2002;21:1-22.
Lee Mao-jung, Malaikal P, Chen L, Meng X, Bondoc F.Y, Prabhu S, et al. Pharmacokinetic of tea catechins after ingestion of green tea and (-)-Epigallocatechin-3-gallate by humans: Formation of different metabolites and individual variability. Cancer Epidemiology, Biomarker & prevention 2002; 11: 1025-1032.
Tousoulis D, Antoniades C, Stefanadis C. Evaluating endothelial function in humans: a guide to invasive and non invasive techniques. Heart 2005;91:553-558.
Ross R. Atherosclerosis-An Inflamatory Disease. New England Journal of Medicine. 1999; 340: 115-126.
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How to Cite
Basalamah, F., Basha, A., & Kusmana, D. (1). Effect of Green Tea on Endothelial Function Assessed by the Flow Mediated Dilatation among Coronary Artery Disease Patients. Indonesian Journal of Cardiology, 28(2), 106-114. https://doi.org/10.30701/ijc.v28i2.254
Section
Clinical Research
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