Despite medical and surgical advances, long-term survival in liver transplant (LT) recipients is compromised by an increased risk of cardiovascular disease (CVD) after transplant, the mechanisms of which are still not fully understood. TMAO is an attractive therapeutic target to improve vascular health and diastolic function toward preventing CVD in LT patients. Therefore, the purpose of this study is to better understand the role of TMAO in cardiovascular dysfunction patients with chronic kidney disease.
Despite medical and surgical advances, long-term survival in liver transplant (LT) recipients is compromised by an increased risk of cardiovascular disease (CVD) after transplant, the mechanisms of which are still not fully understood. Following LT, patients have an increased incidence of atherosclerotic CVD. Notably, atherosclerotic CVD is an established risk factor for diastolic dysfunction and incident heart failure with preserved ejection fraction (HFpEF). There is a critical need to better understand the biological mechanisms of LT related vascular dysfunction and establish targeted interventions that will reduce the risk of CVD in this patient population. In the general population, there is strong epidemiological evidence linking high TMAO levels with atherosclerotic CVD and heart failure, and that it can modulated rapidly by diet within two weeks. Therefore, the purpose of this study is to better understand the role of TMAO in cardiovascular dysfunction patients with chronic kidney disease.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
19
Subjects will consume 50g of cold pressed EVOO per day for 28 days.
Virginia Commonwealth University
Richmond, Virginia, United States
Serum TMAO
Serum TMAO levels will be assessed by nuclear magnetic resonance (NMR)
Time frame: Change from baseline at four weeks
Conduit artery endothelial function changes
Conduit artery endothelial function assessed by flow mediated dilation
Time frame: Change from baseline at four weeks
Microvascular function change
Skin blood flow response to local heating measured by laser doppler flowmetry
Time frame: Change from baseline at four weeks
Arterial hemodynamics changes
Arterial hemodynamics derived from radial artery tonometry recordings
Time frame: Change from baseline at four weeks
Diastolic Function change
Diastolic function at rest by echocardiography and during isometric handgrip exercise
Time frame: Change from baseline at four weeks
Frailty outcome hanges
Frailty outcomes assessed according to Fried criteria
Time frame: Change from baseline at four weeks
Quality of life changes
Quality of Life assessed by SF-36
Time frame: Change from baseline at four weeks
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