BACKGROUND: The number of patients who require non-cardiac surgery following an acute myocardial infarction (AMI) is likely to increase due to aging of surgical population and risk for postoperative heart failure (HF) is increased as effective secondary prevention is missing. Nutritional preconditioning with sustained dietary intake of functional food targets an increase in the functional reserve preoperatively to optimize postoperative cardiac recovery even when the patients are not malnourished. However, a one-size-fits-all approach to nutrition is inappropriate and new personalized functional foods are necessary. Functional bread (FB) made from iron- and zinc-biofortified “Gentil Rosso”, a Tuscan ancient grain, contains higher levels of bioavailable iron (+180%), zinc (+640%), flavonoids (+1000%) and alpha lipoic acid (+50%) compared to regular bread (RB). We hypothesized that the regular intake of normocaloric diet supplemented with FB prevents HF after MI in both sexes. MATERIALS AND METHODS: Adult male and female Wistar rats were subjected to permanent ligation of left anterior descending coronary artery and fed for 6 weeks with normal diet (3.344 kcal/g, 6.2% fat, 18.7% protein, 51% carbohydrate) supplemented with FB (AMI+FB, n=10 males, n=6 females) or normal bread (AMI+RB, n=10 males, n=6 females). Intraperitoneal glucose tolerance test (IPGTT) and cardiac echocardiography were performed before and after diet. The infarct scar size, capillary and arteriolar density were quantified histologically. The myocardial inflammatory response was evaluated by ELISA assay of interleukin (IL)-1α, -1β, -2, -10 and -4. RESULTS Basal plasma glucose levels and IPGTT did not change in both sexes. The decline in left ventricular (LV) ejection fraction of male AMI+FB rats was significantly smaller (-12±1%) compared to male AMI+RB animals (-40±5%). Yet, no differences were detected between female AMI+FB and AMI+RB. The LV infarct scar size of male AMI+FB rats was smaller than male AMI+RB animals (30.5±3 vs 42 ± 3.3%, p<0.001), but no differences were detected in treated female rats. The capillary and arteriolar density in the LV border zone of male AMI+FB rats were higher than untreated male animals (+16.3 vs. +15.35%). We did not find any difference in capillary and arteriolar density in the LV border zone of treated female rats. Finally, lower levels of IL-1α, -1β, -2, -10 and -4 were expressed in the LV border zone of treated male infarcted rats (p<0.01). Conversely, cytokine expression in the remodeled LV region was significantly higher in female AMI+FB animals. CONCLUSIONS: Regular intake of normal diet supplemented with FB hampered cardiac remodeling and limited LV function decay in male, but not female infarcted rats. Bio-fortified bread can be a valid preoperative functional food for suppressing adverse post-AMI cardiac remodeling in a personalized manner.

Ancient grain bread rich in iron, zinc, flavonoids and alpha lipoic acid as a novel preoperative functional food for suppressing the progression of cardiovascular remodeling in infarcted male rats

Casieri V.;Matteucci M.;Ercoli L.;Passino C.;Lionetti V.
2022

Abstract

BACKGROUND: The number of patients who require non-cardiac surgery following an acute myocardial infarction (AMI) is likely to increase due to aging of surgical population and risk for postoperative heart failure (HF) is increased as effective secondary prevention is missing. Nutritional preconditioning with sustained dietary intake of functional food targets an increase in the functional reserve preoperatively to optimize postoperative cardiac recovery even when the patients are not malnourished. However, a one-size-fits-all approach to nutrition is inappropriate and new personalized functional foods are necessary. Functional bread (FB) made from iron- and zinc-biofortified “Gentil Rosso”, a Tuscan ancient grain, contains higher levels of bioavailable iron (+180%), zinc (+640%), flavonoids (+1000%) and alpha lipoic acid (+50%) compared to regular bread (RB). We hypothesized that the regular intake of normocaloric diet supplemented with FB prevents HF after MI in both sexes. MATERIALS AND METHODS: Adult male and female Wistar rats were subjected to permanent ligation of left anterior descending coronary artery and fed for 6 weeks with normal diet (3.344 kcal/g, 6.2% fat, 18.7% protein, 51% carbohydrate) supplemented with FB (AMI+FB, n=10 males, n=6 females) or normal bread (AMI+RB, n=10 males, n=6 females). Intraperitoneal glucose tolerance test (IPGTT) and cardiac echocardiography were performed before and after diet. The infarct scar size, capillary and arteriolar density were quantified histologically. The myocardial inflammatory response was evaluated by ELISA assay of interleukin (IL)-1α, -1β, -2, -10 and -4. RESULTS Basal plasma glucose levels and IPGTT did not change in both sexes. The decline in left ventricular (LV) ejection fraction of male AMI+FB rats was significantly smaller (-12±1%) compared to male AMI+RB animals (-40±5%). Yet, no differences were detected between female AMI+FB and AMI+RB. The LV infarct scar size of male AMI+FB rats was smaller than male AMI+RB animals (30.5±3 vs 42 ± 3.3%, p<0.001), but no differences were detected in treated female rats. The capillary and arteriolar density in the LV border zone of male AMI+FB rats were higher than untreated male animals (+16.3 vs. +15.35%). We did not find any difference in capillary and arteriolar density in the LV border zone of treated female rats. Finally, lower levels of IL-1α, -1β, -2, -10 and -4 were expressed in the LV border zone of treated male infarcted rats (p<0.01). Conversely, cytokine expression in the remodeled LV region was significantly higher in female AMI+FB animals. CONCLUSIONS: Regular intake of normal diet supplemented with FB hampered cardiac remodeling and limited LV function decay in male, but not female infarcted rats. Bio-fortified bread can be a valid preoperative functional food for suppressing adverse post-AMI cardiac remodeling in a personalized manner.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11382/550013
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