Document Detail


High-dose folic acid acutely improves coronary vasodilator function in patients with coronary artery disease.
MedLine Citation:
PMID:  15893170     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We investigated the acute effect of orally administered high-dose folic acid on coronary dilator function in humans.
BACKGROUND: Folic acid and its active metabolite, 5-methyltetrahydrofolate, increase endothelium-dependent vasodilation in human peripheral circulation. However, the acute effect on coronary circulation is not known.
METHODS: Fourteen patients with ischemic heart disease, age 62 +/- 12 years (mean +/- SD), were enrolled in a double-blind, placebo-controlled crossover trial. Basal and adenosine-stimulated myocardial blood flow (MBF) were determined by positron emission tomography, and myocardial flow reserve was calculated. Each patient was studied after ingestion of placebo and after ingestion of 30 mg folic acid. Myocardial zones were prospectively defined physiologically as "normal" versus "abnormal" on the basis of MBF response to adenosine 140 microg/kg/min (normal = MBF >1.65 ml/min/g). Abnormal and normal zones were analyzed separately in a patient-based analysis.
RESULTS: Folate was associated with a reduction in mean arterial pressure (100 +/- 12 mm Hg vs. 96 +/- 11 mm Hg, placebo vs. folate, p < 0.03). Despite the fall in mean arterial pressure, folic acid significantly increased the MBF dose response to adenosine (p < 0.001 using analysis of variance) in abnormal zones, whereas MBF in normal zones did not change. In abnormal segments, folic acid increased peak MBF by 49% (1.45 +/- 0.59 ml/min/g vs. 2.16 +/- 1.01 ml/min/g, p < 0.02). Furthermore, folate increased dilator reserve by 83% in abnormal segments (0.77 +/- 0.59 vs. ml/min/g 1.41 +/- 1.08 ml/min/g, placebo vs. folate, p < 0.05), whereas dilator reserve in normal segments remained unchanged (2.00 +/- 0.61 ml/min/g vs. 2.12 +/- 0.69 ml/min/g, placebo vs. folate, p = NS).
CONCLUSIONS: The data demonstrate that high-dose oral folate acutely lowers blood pressure and enhances coronary dilation in patients with coronary artery disease.
Authors:
Ahmed Tawakol; Raymond Q Migrino; Kusai S Aziz; Justyna Waitkowska; Gotfred Holmvang; Nathaniel M Alpert; James E Muller; Alan J Fischman; Henry Gewirtz
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2005-04-26
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-16     Completed Date:  2005-06-03     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1580-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine (Cardiac Unit), Massachusetts General Hospital, Boston, Massachusetts 02114, USA. atawakol@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use
Aged
Blood Flow Velocity / drug effects
Blood Pressure / drug effects
Coronary Artery Disease / drug therapy*
Coronary Circulation / drug effects*
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Female
Folic Acid / administration & dosage*
Humans
Male
Middle Aged
Positron-Emission Tomography
Prospective Studies
Regional Blood Flow / drug effects
Vasodilation / drug effects*
Grant Support
ID/Acronym/Agency:
K23 RR016046-03/RR/NCRR NIH HHS; RR16046/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
58-61-7/Adenosine; 59-30-3/Folic Acid
Comments/Corrections

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