ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2022 June;29(2):80-6

DOI: 10.23736/S1824-4777.22.01537-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effects of the collagen modulator Centellicum® and spinal elongation exercises on subclinical abdominal aneurysmal dilatation

Gianni BELCARO ¹ ✉, Maria R. CESARONE ^{1, 2}, Mark DUGALL ^{1, 2}, Marcello CORSI ^{1, 2}, Morio HOSOI ^{1, 2}, Pietro M. BAVERA ¹, Roberto COTELLESE ², Beatrice FERAGALLI ², Edmondo IPPOLITO ¹

¹ Irvine3 Institute, Pescara, Italy; ² Department of Medical, Oral and Biotechnological Sciences, D’Annunzio University, Chieti, Italy

BACKGROUND: The aim of this 24-month pilot study was to follow subclinical abdominal aortic aneurysms and investigate the effects of spinal elongations and/or Centellicum^® supplementation on the progressive dilatation of the abdominal aorta.
METHODS: Two groups of patients with subclinical dilatations of the abdominal aorta were formed: 1) standard management (SM), including risk factor controls and vertebral/spinal elongation exercises; 2) SM + Centellicum^® (450 mg/day). A third retrospective control group, previously followed without elongation, was evaluated for comparison.
RESULTS: Thirty-eight patients with subclinical dilatations of the abdominal aorta were included in the study: 19 controls using only SM and 19 subjects additionally supplemented with Centellicum^® 450 mg/day. The retrospective control group consisted of 9 patients. Both prospective groups and the retrospective control group were comparable at inclusion. No tolerability problems were observed. The aortic diameter increased progressively from 28.4±0.7 mm at baseline to 32.9±0.5 mm at 18 months to 38.0±0.3 at 24 months in the controls not taking supplementation but SM including elongation exercises. In the subjects supplemented with Centellicum^® in addition to standard management, the aortic diameter remained almost unchanged from 28.3±0.6 mm at baseline to 28.2±0.3 mm at 18 months and 28.9±0.4 at 24 months. The difference in diameter between the two groups is statistically significant after 18 and 24 months. The rate of diameter increase in the SM-only subjects was higher at 18 and 24 months in comparison with the supplemented subjects. There is a statistically significant difference (P<0.05) between aortic dilatation over time in subjects in the retrospective control group with the most significant enlargement, and subjects in SM, with moderately reduced progression, and in SM+Centellicum^® (P<0.05) with an almost stable aortic diameter. The spinal elongation program possibly reduced the progressive dilatation but the supplementation with Centellicum^® prevented further aortic dilatation. No cardiovascular events were observed during the registry. The spinal length remained constant (at 24 months) in the retrospective control group whereas elongation exercises increased the vertebral length of 2.6±0.4 cm in the SM group; the increase in length was of 3.1±0.3 cm in the SM+supplementation group. This was attributed to an improvement in thickness of the intervertebral discs due to improved perfusion and collagen repositioning when the compression of the disc was reduced.
CONCLUSIONS: The progression of aortic dilatation was decreased by spinal elongation and even stopped when it was combined with Centellicum^® supplementation. Both contribute to intervertebral disc re-expansion. It is possible that Centellicum^® contributes to prevent aortic dilatation by collagen modulation within both discs and aortic wall. The incorporation of collagen in the discs and in the aortic walls could synergistically help to slow down the dilatation of the abdominal aorta.

KEY WORDS: Dietary supplements; Spine; Aortic aneurysm, abdominal; Centella asiatica extract