Impact of olive oil extracts in myocardial and vascular function of patients with chronic cononary syndromes

Abstract Background A recent study demonstrated that supplementation with an olive oil product enriched with hydroxytyrosol (HT) effectively reduces oxidative stress and inflammatory biomarkers, enhances endothelial and arterial function, and improves the diastolic performance of the left ventricle in patients with chronic coronary syndromes over a short treatment period. Purpose Building on these findings, we hypothesized that an oral supplement, containing olive oil extract enriched with oleuropein (OL), hydroxytyrosol (HT), and oleocanthal (OLEO), could further reduce oxidative stress and enhance cardiovascular and vascular markers in patients with chronic coronary syndromes. Methods To investigate this, we conducted a prospective, randomized, crossover, double-blind, placebo-controlled clinical trial. Fifteen patients with chronic coronary syndromes were randomly assigned to receive either a supplement containing OL, HT, and OLEO in a 2:1:3 ratio or a placebo for one month. Evaluations were performed before treatment, after one month of placebo administration, and following one month of administration of olive extract supplement. The assessments included: a) Perfused Boundary Region (PBR), an inverse indicator of endothelial glycocalyx thickness in sublingual arterioles (5–25 μm range), b) Endothelium-dependent vasodilation (FMD) of the brachial artery, c) Coronary flow reserve (CFR) of the anterior descending artery using Doppler echocardiography, d) Pulse wave velocity (PWV) and central systolic blood pressure (cSBP), e) Serum concentration of malondialdehyde (MDA), an oxidative stress marker. Results Data analysis showed that the olive extracts supplement significantly improved vascular markers, including FMD and CFR, compared to baseline, whereas no such changes were observed with the placebo (Table 1). Additionally, the supplement enhanced diastolic function, as reflected in improvements in E’, E/e’, DT, and LVGLS values (Table 2). The supplement also led to a significant reduction in oxidative stress markers, including MDA and oxidized LDL cholesterol, compared to baseline, whereas no significant changes were noted following placebo administration (Table 3). Comparing the effects of HT supplement with the supplement containing OL, HT, and OLEO in a 2:1:3 ratio, the second induced significant improvements in left ventricular longitudinal strain values and glycocalyx integrity in vessels measuring 20-25 μm (Table 4). Conclusion Overall, while both supplements provide cardiovascular benefits primarily through the action of HT, the formulation including three substances appears to offer additional advantages by further enhancing endothelial function, coronary artery performance, and myocardial strain through a greater reduction in oxidative stress.