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Impact Of Chronic Antioxidant Administration On Microvascular Function In Heart Failure With Reduced Ejection Fraction: 2117
Abstract   Peer reviewed

Impact Of Chronic Antioxidant Administration On Microvascular Function In Heart Failure With Reduced Ejection Fraction: 2117

Edward Z. Pelka, Stephen M. Ratchford, Jeremy K. Alpenglow, Soung H. Park, Catherine L. Jarrett, Josef Stehlik, D. Walter Wray and Kanokwan Bunsawat
Medicine and science in sports and exercise, Vol.58(10S), 2117
10/2026
DOI: 10.1249/01.mss.0001265460.15465.6c

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Abstract

Heart failure with reduced ejection fraction (HFrEF) is characterized by micro- and macrovascular dysfunction due, in part, to oxidative stress. We documented an improvement in macrovascular function following chronic antioxidant (AOx) administration in patients with HFrEF, but whether microvascular function would also benefit from this nutraceutical intervention remains unclear. PURPOSE: We sought to test the hypothesis that chronic AOx administration improves microvascular function in patients with HFrEF. METHODS: Thirteen patients with HFrEF (age: 70±9 years; LV ejection fraction: 33±9%; NYHA class II-III) underwent 30 days of oral AOx administration (1 g vitamin C, 600 I.U. vitamin E and 0.6 g α-lipoic acid). Locomotor muscle microvascular function was assessed as leg blood flow (LBF) responses to passive leg movement and was expressed as peak change (Δpeak). Plasma AOx capacity was assessed via the Ferric reducing AOx power (FRAP). Statistical comparisons were conducted using paired sample t-tests (full cohort; Day 0/Day 30), 2x2 ANOVA with repeated measures (responders/non-responders [based on a waterfall plot]; Day 0/Day 30), and the Pearson correlations on change values (Day 30 minus Day 0) in responders and non-responders. RESULTS: In the full cohort, chronic AOx administration did not change LBFΔpeak (Day 0: 349±130 vs. Day 30: 357±156 mL/min; p = 0.777) but increased FRAP (Day 0: 6.08±1.36 vs. Day 30: 6.70±1.59 mmol/L; p = 0.005). When categorized into responders (n=6) and non-responders (n=7), LBFΔpeak (p = 0.001 for interaction), but not FRAP (p = 0.463 for interaction), responded differently between subgroups. LBFΔpeak increased in responders (Day 0: 356±100 vs. Day 30: 562±345 mL/min; p = 0.006) and decreased in non-responders (Day 0: 341±153 vs. Day 30: 282±120 mL/min; p = 0.026). The changes in LBFΔpeak were positively correlated with the changes in FRAP concentrations (r = 0.924; p = 0.008) only in the responders. CONCLUSIONS: Chronic AOx administration may be effective in improving locomotor muscle microvascular function in some patients with HFrEF due, in part, to AOx-induced alterations in redox balance. These findings highlight the efficacy of non-pharmacologic approaches for improving vascular health in this heterogeneous patient group.

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