A human study on the popular supplement resveratrol on heart failure patients has been published, and the results are significant.
What is resveratrol?
Resveratrol, is a naturally occurring stilbenoid, a type of phenol that is present in various plants and foods, such as grapes, peanuts, cocoa, blueberries, raspberries, and cranberries. It is frequently mentioned as being a component of red wine rather than white wine, and this is because it is found in the grape skins that are used in the creation of red wine.
Resveratrol is known to increase the activity of SIRT1, often called the longevity gene, in multiple species, and it influences the development of fat cells. Given these qualities, resveratrol has been of interest as a potential candidate for treating cardiovascular disease. Indeed, there is human data suggesting that resveratrol supplementation decreases apolipoprotein-B and LDL cholesterol levels, whose excessive presence contributes to cardiovascular disease [1-2].
What did the study show?
The results of this study suggest that resveratrol may be beneficial for people suffering from heart failure [3]. Certainly, previous animal studies on this topic have achieved positive results, but, until now, the effects in people with heart failure had not been explored.
This was a small three-month human trial involving 60 participants, who were all suffering from heart failure and New York Heart Association class II-III symptoms for their condition. Class II is a category of mild symptoms, such as mild shortness of breath and/or angina with some limitations on performing ordinary activity. Class III symptoms include more serious limitations to regular activity and even difficulty during light activity, such as walking short distances.
For this study, half the participants were given a placebo, and the other half were given 100 milligrams of resveratrol every day for three months.
At the start and end of the study, the participants each had an echocardiogram, which uses ultrasound to show how the heart muscle and valves are functioning. In addition, a six-minute walk test, a quality of life questionnaire, a lung function test, and an RNA profile analysis were performed.
The results showed that the participants given resveratrol saw an improvement in systolic and diastolic left ventricular function and global longitudinal strain. This suggests that there was some improvement to heart function in these participants. This is supported by the increase of exercise capacity and improved ventilation metrics taken. There was also some improvement to participant quality of life according to the questionnaire they were given, though such things are subjective, of course.
The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in blood samples also showed a significant reduction. NT-proBNP levels go up when the heart cannot pump blood around the body as well as it should. The higher the level, the more likely that heart failure is present and the more severe it typically is.
There was also a marked reduction of galectin-3 in people treated with resveratrol. Galectin-3 is a proinflammatory lectin that can bind to β-galactoside and is secreted by activated macrophages. Galectin-3 is often used as a biomarker for heart failure.
Finally, in the resveratrol group, the levels of inflammatory cytokines IL-1 and IL-6 were significantly reduced. However, C-reactive protein and ferritin, whose elevated levels are commonly associated with heart failure, showed no significant change. There was also no significant change to white blood cell count, another biomarker of inflammation and heart failure.
The effects of resveratrol (RES) in heart failure have already been evaluated in animal models; however, in human clinical trials, they have not been confirmed yet. The aim of this study was to assess the effects of resveratrol treatment in systolic heart failure patients (heart failure with reduced ejection fraction or HFrEF). In this human clinical trial, 60 outpatients with NYHA (New York Heart Association) class II-III HFrEF were enrolled and randomized into two groups: receiving either 100-mg resveratrol daily or placebo for three months. At the beginning and at the end of the study echocardiography, a six-minute walk test, spirometry, quality of life questionnaire, lab test and RNA profile analysis were performed. The systolic and diastolic left ventricular function, as well as the global longitudinal strain, were improved significantly in the resveratrol-treated group (RES). Exercise capacity, ventilation parameters and quality of life also improved significantly in the RES group. In parallel, the cardiac biomarker levels (N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3) decreased in the treated group. The level of inflammatory cytokines decreased significantly after RES supplementation, as a consequence of the decreased expression level of leucocyte electron transport chain proteins. The main findings of our trial are that RES treatment added to the standard heart failure therapy improved heart function and the clinical condition by moderating the inflammatory processes in patients with HFrEF.
Conclusion
These results are mostly positive, though, as the researchers themselves correctly point out, this initial study has some limitations. As it has a small group and a fairly short follow-up period, it should be followed up by a larger-scale trial, ideally one with a longer treatment and follow-up period.
Literature
[1] Magyar, K., et al. (2012). Cardioprotection by resveratrol: A human clinical trial in patients with stable coronary artery disease. Clinical Hemopheology and Microcirculation, 50(3): 179-187.
[2] Tomé-Carneiro, J., (2012). Consumption of a grape extract supplement containing resveratrol decreases oxidized LDL and ApoB in patients undergoing primary prevention of cardiovascular disease: a triple-blind, 6-month follow-up, placebo-controlled, randomized trial. Molecular Nutrition and Food Research, 56(5): 810-821.
[3] Gal, R., Deres, L., Horvath, O., Eros, K., Sandor, B., Urban, P., … & Habon, T. (2020). Resveratrol Improves Heart Function by Moderating Inflammatory Processes in Patients with Systolic Heart Failure. Antioxidants, 9(11), 1108.
