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Cardiovascular effects of flavanol-rich chocolate in patients with heart failure.
Eur Heart J. 2012 Sep; 33(17):2172-80.EH

Abstract

AIMS

Flavanol-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 RESULTS

Twenty 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.

CONCLUSION

Flavanol-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.

Authors+Show Affiliations

Cardiovascular Center, Cardiology University Hospital Zurich, Raemistrasse 100, Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22173910

Citation

Flammer, Andreas J., et al. "Cardiovascular Effects of Flavanol-rich Chocolate in Patients With Heart Failure." European Heart Journal, vol. 33, no. 17, 2012, pp. 2172-80.
Flammer AJ, Sudano I, Wolfrum M, et al. Cardiovascular effects of flavanol-rich chocolate in patients with heart failure. Eur Heart J. 2012;33(17):2172-80.
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), 2172-80. https://doi.org/10.1093/eurheartj/ehr448
Flammer AJ, et al. Cardiovascular Effects of Flavanol-rich Chocolate in Patients With Heart Failure. Eur Heart J. 2012;33(17):2172-80. PubMed PMID: 22173910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular effects of flavanol-rich chocolate in patients with heart failure. AU - Flammer,Andreas J, AU - Sudano,Isabella, AU - Wolfrum,Mathias, AU - Thomas,Rajeev, AU - Enseleit,Frank, AU - Périat,Daniel, AU - Kaiser,Priska, AU - Hirt,Astrid, AU - Hermann,Matthias, AU - Serafini,Mauro, AU - Lévêques,Antoine, AU - Lüscher,Thomas F, AU - Ruschitzka,Frank, AU - Noll,Georg, AU - Corti,Roberto, Y1 - 2011/12/15/ PY - 2011/12/17/entrez PY - 2011/12/17/pubmed PY - 2013/1/1/medline SP - 2172 EP - 80 JF - European heart journal JO - Eur. Heart J. VL - 33 IS - 17 N2 - AIMS: Flavanol-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 RESULTS: Twenty 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. CONCLUSION: Flavanol-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. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/22173910/Cardiovascular_effects_of_flavanol_rich_chocolate_in_patients_with_heart_failure_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehr448 DB - PRIME DP - Unbound Medicine ER -