Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-53537
Flammer, A J; Sudano, I; Wolfrum, M; Thomas, R; Enseleit, F; Périat, D; Kaiser, P; Hirt, A; Hermann, M; Serafini, M; Lévêques, A; Lüscher, T F; Ruschitzka, F; Noll, G; Corti, R (2012). Cardiovascular effects of flavanol-rich chocolate in patients with heart failure. European Heart Journal, 33(17):2172-2180.
AimsFlavanol-rich chocolate (FRC) is beneficial for vascular and platelet function by increasing nitric oxide bioavailability and decreasing oxidative stress. Congestive heart failure (CHF) is characterized by impaired endothelial and increased platelet reactivity. As statins are ineffective in CHF, alternative therapies are a clinical need. We therefore investigated whether FRC might improve cardiovascular function in patients with CHF.Methods and resultsTwenty patients with CHF were enrolled in a double-blind, randomized placebo-controlled trial, comparing the effect of commercially available FRC with cocoa-liquor-free control chocolate (CC) on endothelial and platelet function in the short term (2 h after ingestion of a chocolate bar) and long term (4 weeks, two chocolate bars/day). Endothelial function was assessed non-invasively by flow-mediated vasodilatation of the brachial artery. Flow-mediated vasodilatation significantly improved from 4.98 ± 1.95 to 5.98 ± 2.32% (P = 0.045 and 0.02 for between-group changes) 2h after intake of FRC to 6.86 ± 1.76% after 4 weeks of daily intake (P = 0.03 and 0.004 for between groups). No effect on endothelial-independent vasodilatation was observed. Platelet adhesion significantly decreased from 3.9 ± 1.3 to 3.0 ± 1.3% (P = 0.03 and 0.05 for between groups) 2 h after FRC, an effect that was not sustained at 2 and 4 weeks. Cocoa-liquor-free CC had no effect, either on endothelial function or on platelet function. Blood pressure and heart rate did not change in either group.ConclusionFlavanol-rich chocolate acutely improves vascular function in patients with CHF. A sustained effect was seen after daily consumption over a 4-week period, even after 12 h abstinence. These beneficial effects were paralleled by an inhibition of platelet function in the presence of FRC only.Trial Registration ClinicalTrials.gov Identifier: NCT00538941.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology|
08 University Research Priority Programs > Integrative Human Physiology
|DDC:||610 Medicine & health|
|Deposited On:||26 Feb 2012 18:35|
|Last Modified:||27 Nov 2013 19:45|
|Publisher:||Oxford University Press|
|Additional Information:||This is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Heart Journal following peer review. The definitive publisher-authenticated version Flammer, A J; Sudano, I; Wolfrum, M; Thomas, R; Enseleit, F; Périat, D; Kaiser, P; Hirt, A; Hermann, M; Serafini, M; Lévêques, A; Lüscher, T F; Ruschitzka, F; Noll, G; Corti, R (2011). Cardiovascular effects of flavanol-rich chocolate in patients with heart failure. European Heart Journal:Epub ahead of print is available online at: http://eurheartj.oxfordjournals.org/content/early/2011/12/15/eurheartj.ehr448|
|Citations:||Web of Science®. Times Cited: 9|
Scopus®. Citation Count: 10
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