Myocardial Protection, Perioperative Management, and Vascular Biology Resveratrol Improves Myocardial Perfusion in a Swine Model of Hypercholesterolemia and Chronic Myocardial Ischemia

Background—Resveratrol may provide protection against coronary artery disease. We hypothesized that supplemental resveratrol will improve cardiac perfusion in the ischemic territory of swine with hypercholesterolemia and chronic myocardial ischemia. Methods and Results—Yorkshire swine were fed either a normal diet (control, n 7), a hypercholesterolemic diet (HCC, n 7), or a hypercholesterolemic diet with supplemental resveratrol (100 mg/kg/d orally, HCRV, n 7). Four weeks later, an ameroid constrictor was placed on the left circumflex artery. Animals underwent cardiac MRI and coronary angiography 7 weeks later before euthanasia and tissue harvest. Total cholesterol was lowered about 30% in HCRV animals (P 0.001). Regional wall motion analysis demonstrated a significant decrease in inferolateral function from baseline to 7 weeks in HCC swine (P 0.04). There was no significant change in regional function in HCRV swine from baseline to 7 weeks (P 0.32). Tissue blood flow during stress was 2.8-fold greater in HCRV swine when compared with HCC swine (P 0.04). Endothelium-dependent microvascular relaxation response to Substance P was diminished in HCC swine, which was rescued by resveratrol treatment (P 0.004). Capillary density (PECAM-1 staining) demonstrated fewer capillaries in both HCC and HCRV swine versus control swine (P 0.02). Immunoblot analysis demonstrated significantly greater expression in HCRV versus HCC swine of the following markers of angiogenesis: VEGF (P 0.002), peNOS (ser1177) (P 0.04), NFkB (P 0.004), and pAkt (thr308) (P 0.001). Conclusions—Supplemental resveratrol attenuates regional wall motion abnormalities, improves myocardial perfusion in the collateral dependent region, preserves endothelium-dependent coronary vessel function, and upregulates markers of angiogenesis associated with the VEGF signaling pathway. (Circulation. 2010;122[suppl 1]:S142–S149.)