Successful improved peripheral tissue perfusion was seen in patients with atherosclerosis after 12 months of treatment with aged garlic extract

Abstract

Patients with arteriolosclerosis have impaired microvascular perfusion leading to impaired wound healing. Aged garlic extract has shown to have a positive impact on vascular elasticity. The present study aimed to assess the effect of long-term treatment with AGE on peripheral tissue perfusion in patients with confirmed atherosclerosis. Ninety three patients with a CT-scan confirmed coronary artery arteriolosclerosis were randomised in a double-blind manner to placebo or 2400 mg AGE daily for 1 year. Peripheral tissue perfusion was evaluated at 0- and 12-months using Laser Speckle Contrast Imaging. Measurement of post occlusive reactive hyperemia (PORH) and cutaneous vascular conductance (CVC) using acetylcholine iontophoresis (Ach) was conducted. After 12 months a significant increase of 21.6% (95% CI 3.2%-40.0%, P < .05) was seen in the relative change of PORH in the AGE compared with the placebo group. The same response was seen for CVC and Ach with an increase of 21.4% (95% CI 3.4%-39.4%, P < .05) in the AGE group compared with the placebo group. Aged garlic extract regenerated peripheral tissue perfusion and increase microcirculation in patients with arteriolosclerosis. Adequate peripheral tissue perfusion and tissue oxygen tension are important prerequisites for successful tissue repair. Restored microcirculation in patients could hypothetically facilitate wound healing.

Keywords: aged garlic extract; atherosclerosis; double blinded; laser speckle contrast imaging; peripheral tissue perfusion.

FIGURE 1

Illustration of the clinical Laser speckle contrast imaging (LSCI) setup for post occlusive reactive hyperemia (PORH) analysis (A). The LSCI camera was framed at the forearm of the study subjects, the red aiming beams are visualised. A blood pressure cuff was inflated to cause occlusion of the blood flow. The measurements, here illustrated with a representative example (B), were made on the forearm before before (B), during (O) and after (P) blood flow occlusion, to estimate the PORH. The time of interest for the measurements are illustrated with the colour bars in the in (B) and the region of interest are illustrated with the green circles in both (A) and the LSCI images in (B)

FIGURE 2

CONSORT statement (consolidated standards of reporting trials) flow chart. Showing demographics and baseline clinical information of the study cohort

FIGURE 3

Increased post occlusive reactive hyperemia (PORH) response in patients treated with AGE. Peripheral tissue perfusion was measured at 0‐ and 12‐months. Measurements were done before, during and after partial occlusion using a blood pressure cuff creating a post occlusive reactive hyperemia (PORH) response. A significant increase in relative change in PORH was seen in the AGE group compared with the placebo group (P < .05)

FIGURE 4

Improved endothelial function in patients treated with AGE. Endothelial function and vascular response were measured at 0‐ and 12‐months using iontophoresis and acetylcholine (Ach) provocation. Measurements, cutaneous vascular conductance (CVC) was calculated at rest and at peak vasodilatation in the first 5 minutes following ACh iontophoresis. A significant increase in relative change in CVC was seen in the AGE group compared with the placebo group (P < .05)