Treatment of Cardiovascular Diseases
Research Summary

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References
  • Drake KJ. Amino acids as metabolic substrates during cardiac ischemia. Exp Biol Med (Maywood).  2012 Dec;237(12):1369-78.                                                                              
  • Marazzi G. The role of amino acids in the modulation of cardiac metabolism during ischemia and heart failure. Curr Pharm Des. 2008;14(25):2592-604.

During ischemia and heart failure, myocardial cells suffer for chronic energy starvation resulting in metabolic and contractile dysfunction. In normal conditions fatty acids, glucose, and lactate are the principal oxidative fuels in myocardium, while amino acids serve a minor role as an oxidative fuel. However, in pathological conditions, myocardial uptake of several amino acids increases significantly as a consequence of a metabolic remodelling.

  • Pasini E. Effect of amino acid mixture on the isolated ischemic heart. Am J Cardiol. 2004 Apr 22;93 (8A): 30A-34A.                                                                                                                           

Data show that uptake of amino acids correlates with myocardial oxygen consumption after aortic cross-clamp in humans; this suggests a direct link between amino acids and myocardial energy metabolism. We conclude that long-term supplementation of an amino acid mixture reduced myocardial ischemic damage.

  • Scognamiglio R. Early myocardial dysfunction in the diabetic heart: current research and clinical applications. Am J Cardiol. 2004 Apr 22;93(8A):17A-20A.    

Diabetes is associated with an increased or poorly regulated rate of amino acid catabolism at the cardiac level. Increasing the supply of amino acids in addition to conventional therapy significantly attenuates this phenomenon.

  • Scognamiglio R.Effects of oral amino acid supplements on cardiac function and remodelling in patients with  type 2 diabetes with mild-to-moderate left ventricular dysfunction.  Am J Cardiol.  2008 Jun 2;101 (11A ) : 111E -115E.
  • Jennings A.  Amino Acid Intakes Are Inversely Associated with Arterial Stiffness and Central Blood Pressure in Women. J Nutr. 2015 Sep;145(9):2130-8.                                                                                   

We examined associations between intakes of AAs with known mechanistic links to cardiovascular health and direct measures of arterial stiffness, central blood pressure, and atherosclerosis.  INCREASING INTAKES OF THESE AAS COULD BE AN IMPORTANT AND READILY ACHIEVABLE WAY TO REDUCE CARDIOVASCULAR DISEASE RISK.

  • Jahidur Rashid et al. Therapeutic Potential of Citrulline as an Arginine Supplement: A Clinical Pharmacology Review.  Paediatr Drugs. 2020 Jun;22(3):279-293.

Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction.

In clinical studies in adults, L-arginine, an endogenous amino acid, was reported to improve cardiovascular function in hypertension, pulmonary hypertension, preeclampsia, angina, and MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) syndrome.

  • Pasini E. Amino acids:  chemistry and metabolism in normal and hypercatabolic states. Am J Cardiol.  2004 Apr 22;93(8A):3A-5A.        

 Amino acid supplementation may be effective in counteracting the metabolic and morphologic consequences of the hypercatabolic state of chronic diseases such as heart failure, diabetes mellitus, or liver cirrhosis.

  • Aquilani R.  Oral amino acid supplements improve exercise capacities in elderly patients with chronic heart failure. Am J Cardiol. 2008; 101:104E‐110E
  • Nisoli E.  Amino acids and mitochondrial biogenesis. Am J Cardiol. 2008 Jun 2;101(11A):22E-25E.

Here, we suggest that some types of nutrients, including specific mixtures of amino acids, may improve mitochondrial biogenesis and energy production in energy-defective conditions by increasing endothelial NO synthase expression.

  • Tuttle KR.  Dietary amino acids and blood pressure: A cohort study of patients with cardiovascular disease.  AM J Kidney Dis. 2012 Feb 28
  • Ulrich Förstermann et al. Nitric oxide synthases: regulation and function.  Eur Heart J. 2012 Apr;33(7):829-37, 837a-837d.
  • Lekakis J.  Oral l-arginine improves endothelial dysfunction in patients with essential hypertension. J Am Coll Cardiol. 2001:260A.
  • Ceremuzynski L.  Effect of supplemental oral L-arginine on exercise capacity in patients with stable angina pectoris. Am J Cardiol. 1997;80:331-333.
  • Rector TS. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation. 1996;93:2135-2141.
  • Siani A. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens. 2000 May;13(5 Pt 1):547-51.

These results indicate that a moderate increase in L-arginine significantly lowered blood pressure and affected renal function and carbohydrate metabolism in healthy volunteers.

  • Gusev EI.  Neuroprotective effects of glycine for therapy of acute ischaemic stroke. Cerebrovasc  Dis. 2000;10:49-60.
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