Effect of Melatonin Supplementation on Endothelial Function in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blinded Clinical Trial Publisher Pubmed



Hoseini SG^{1, 2} ; Heshmatghahdarijani K³ ; Khosrawi S² ; Garakyaraghi M³ ; Shafie D³ ; Roohafza H⁴ ; Mansourian M¹ ; Azizi E⁴ ; Gheisari Y⁵ ; Sadeghi M⁴ Show Affiliations
Source: Clinical Cardiology Published:2021

Abstract

Background: This study aimed to investigate the effect of melatonin supplementation on endothelial function in patients with heart failure with reduced ejection fraction (HFrEF). Methods: This is an analysis of the MeHR trial, a randomized double-blinded placebo-controlled clinical trial with two parallel arms of 1:1. Oral 10 mg melatonin tablets or placebo was administered for 24 weeks. Deference in the percentage of flow-mediated dilatation (FMD) after the intervention was the primary outcome. Results: Ninety-two patients were included in the study (age: 62.7±10.3 years, 87.0% male, ejection fraction (EF): 28.6±8.1). After adjustment for baseline FMD and age, a statistically significant difference in post-treatment FMD in favor of the melatonin group was seen (estimated marginal means [95%CI], melatonin: 7.84% [6.69–8.98], placebo: 5.98% [4.84–7.12], p =.027). There was no significant difference in the mean of post-treatment systolic/diastolic blood pressure, serum total antioxidant capacity, and serum malondialdehyde (MDA) between groups. Subgroup analysis showed significant improvement in FMD and MDA in the melatonin group in nondiabetic patients, while no difference was seen between study groups in diabetic patients. Conclusions: Melatonin supplementation in HFrEF might improve endothelial function; however, this beneficial effect might not be seen in diabetic patients. © 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.