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Emerging role for antioxidant therapy in protection against diabetic cardiac complications: experimental and clinical evidence for utilization of classic and new antioxidants.

Hill MF - Curr Cardiol Rev (2008)

Bottom Line: Diabetes mellitus (DM) markedly potentiates the risk of cardiovascular morbidity and mortality among individuals with diabetes as compared to the non-diabetic population.The excess mortality and poor prognosis of these patients results primarily from the development of recurrent MI and heart failure (HF).In this review, we provide the emergence of experimental and clinical evidence supporting antioxidant supplementation as a cardioprotective intervention in the setting of DM.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

ABSTRACT
Diabetes mellitus (DM) markedly potentiates the risk of cardiovascular morbidity and mortality among individuals with diabetes as compared to the non-diabetic population. After myocardial infarction (MI), DM patients have a higher incidence of death than do non-diabetics. The excess mortality and poor prognosis of these patients results primarily from the development of recurrent MI and heart failure (HF). Although several lines of evidence support a role for increased oxidative stress in a range of cardiovascular diseases, clinical trials examining the therapeutic efficacy of antioxidants have yielded conflicting results. The reasons for these incongruous results is multifactorial. An underlying theme has been lack of patient inclusion based on elevated indices of oxidative stress which could have diluted the population susceptible to benefit in the clinical trials. Laboratory evidence has accumulated indicating that oxidative stress is dramatically accentuated in cardiac abnormalities inherent in DM. In this review, we provide the emergence of experimental and clinical evidence supporting antioxidant supplementation as a cardioprotective intervention in the setting of DM. Specifically, focus will be directed on preclinical animal studies and human clinical trials that have tested the effect of antioxidant supplements on MI and HF events in the presence of DM.

No MeSH data available.


Related in: MedlinePlus

Representative left ventricular (LV) pressure recordings and maximal rate of LV pressure rise and fall (±dP/dt) obtained from control and STZ-induced diabetic rats with and without vitamin E (Vit E) treatment: (A) control rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (B) control rat maintained on a vitamin E-supplemented (+Vit E) diet; (C) STZ-diabetic rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (D) STZ-diabetic rat maintained on a vitamin E-supplemented (+Vit E) diet. Reprinted from Ref. 53 (Copyright 2007), with permission from Elsevier.
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Figure 1: Representative left ventricular (LV) pressure recordings and maximal rate of LV pressure rise and fall (±dP/dt) obtained from control and STZ-induced diabetic rats with and without vitamin E (Vit E) treatment: (A) control rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (B) control rat maintained on a vitamin E-supplemented (+Vit E) diet; (C) STZ-diabetic rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (D) STZ-diabetic rat maintained on a vitamin E-supplemented (+Vit E) diet. Reprinted from Ref. 53 (Copyright 2007), with permission from Elsevier.

Mentions: We recently investigated whether dietary vitamin E supplementation could confer cardioprotection against HF in type I diabetic cardiomyopathy. We found that supplementation of STZ-diabetic rats with 2000 IU of vitamin E/kg feed beginning immediately after induction of DM and continuing for 8 weeks provided significant protection against cardiac dysfunction induced by type 1 DM (Fig. 1 and Table 1) and that this cardioprotective effect was simultaneously associated with an ability of vitamin E to blunt diabetes-induced amplification of myocardial 8-iso PGF2α and GSSG formation [53]. These findings suggest the usefulness of vitamin E supplementation during the early phases of type 1 DM for the prophylaxis of cardiomyopathy and subsequent HF.


Emerging role for antioxidant therapy in protection against diabetic cardiac complications: experimental and clinical evidence for utilization of classic and new antioxidants.

Hill MF - Curr Cardiol Rev (2008)

Representative left ventricular (LV) pressure recordings and maximal rate of LV pressure rise and fall (±dP/dt) obtained from control and STZ-induced diabetic rats with and without vitamin E (Vit E) treatment: (A) control rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (B) control rat maintained on a vitamin E-supplemented (+Vit E) diet; (C) STZ-diabetic rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (D) STZ-diabetic rat maintained on a vitamin E-supplemented (+Vit E) diet. Reprinted from Ref. 53 (Copyright 2007), with permission from Elsevier.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2801857&req=5

Figure 1: Representative left ventricular (LV) pressure recordings and maximal rate of LV pressure rise and fall (±dP/dt) obtained from control and STZ-induced diabetic rats with and without vitamin E (Vit E) treatment: (A) control rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (B) control rat maintained on a vitamin E-supplemented (+Vit E) diet; (C) STZ-diabetic rat maintained on a basal, un-supplemented vitamin E (-Vit E) diet; (D) STZ-diabetic rat maintained on a vitamin E-supplemented (+Vit E) diet. Reprinted from Ref. 53 (Copyright 2007), with permission from Elsevier.
Mentions: We recently investigated whether dietary vitamin E supplementation could confer cardioprotection against HF in type I diabetic cardiomyopathy. We found that supplementation of STZ-diabetic rats with 2000 IU of vitamin E/kg feed beginning immediately after induction of DM and continuing for 8 weeks provided significant protection against cardiac dysfunction induced by type 1 DM (Fig. 1 and Table 1) and that this cardioprotective effect was simultaneously associated with an ability of vitamin E to blunt diabetes-induced amplification of myocardial 8-iso PGF2α and GSSG formation [53]. These findings suggest the usefulness of vitamin E supplementation during the early phases of type 1 DM for the prophylaxis of cardiomyopathy and subsequent HF.

Bottom Line: Diabetes mellitus (DM) markedly potentiates the risk of cardiovascular morbidity and mortality among individuals with diabetes as compared to the non-diabetic population.The excess mortality and poor prognosis of these patients results primarily from the development of recurrent MI and heart failure (HF).In this review, we provide the emergence of experimental and clinical evidence supporting antioxidant supplementation as a cardioprotective intervention in the setting of DM.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

ABSTRACT
Diabetes mellitus (DM) markedly potentiates the risk of cardiovascular morbidity and mortality among individuals with diabetes as compared to the non-diabetic population. After myocardial infarction (MI), DM patients have a higher incidence of death than do non-diabetics. The excess mortality and poor prognosis of these patients results primarily from the development of recurrent MI and heart failure (HF). Although several lines of evidence support a role for increased oxidative stress in a range of cardiovascular diseases, clinical trials examining the therapeutic efficacy of antioxidants have yielded conflicting results. The reasons for these incongruous results is multifactorial. An underlying theme has been lack of patient inclusion based on elevated indices of oxidative stress which could have diluted the population susceptible to benefit in the clinical trials. Laboratory evidence has accumulated indicating that oxidative stress is dramatically accentuated in cardiac abnormalities inherent in DM. In this review, we provide the emergence of experimental and clinical evidence supporting antioxidant supplementation as a cardioprotective intervention in the setting of DM. Specifically, focus will be directed on preclinical animal studies and human clinical trials that have tested the effect of antioxidant supplements on MI and HF events in the presence of DM.

No MeSH data available.


Related in: MedlinePlus