The major polyphenol (-)-epigallocatechin gallate (EGCG) of green tea shows well-known health benefits such as potential anti-cancer, anti-oxidation and ameliorating cardiovascular disease. This work aims to improve the bioactivity of EGCG on H9C2 cardiomyocytes by combination regimen of vardenafil and EGCG. The proliferative rates were significantly improved by 18.74%, 10.77% and 29.17% after 48 h with EGCG, vardenafil, and the combination of EGCG and low-dose vardenafil treatments, respectively. The treatments also increased the expression of the nitric oxide synthase (eNOS), and acutely stimulate production of vasodilators nitric oxide (NO) from 17.33μmol/L to 19.75, 20.87 and 24.47μmol/L in H9C2 cells. We further demonstrated that vardenafil also remarkably promoted EGCG to counteract HO-induced apoptotic damage in H9C2 by strengthening antioxidant defense systems and suppressing myocardial apoptosis. These results suggest that EGCG and low-dose vardenafil in combination may be a promising regimen to help prevent cardiovascular diseases.
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