BACKGROUND: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. METHODS: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 +/- 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. RESULTS: The VO2 peak increased 26% in the Trained patients (15.4 +/- 4.3 vs 19.4 +/- 5.5 ml/kg/min; p < or = 0.05) but did not change in the Controls (16.2 +/- 5.2 vs 16.8 +/- 2.8 ml/kg/min; p > or = 0.05). Brachial artery flow-mediated dilation (10.1% +/- 6.1% vs 9.6% +/- 6.2%) and absolute brachial diameter (0.48 +/- 0.22 vs 0.42 +/- 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5% +/- 2.8% vs 7.9% +/- 5.1%) and the absolute change in brachial diameter (0.48 +/- 0.16 vs 0.36 +/- 0.24 mm) decreased significantly (p < or = 0.05) in the Control patients. Resting norepinephrine decreased significantly (p < or = 0.05) after training (0.32 +/- 0.19 vs 0.22 +/- 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 +/- 0.17 vs 0.53 +/- 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. CONCLUSIONS: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate insupervised exercise showed a progressive decline in brachial artery flow-mediated dilation.
RCT Entities:
BACKGROUND: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. METHODS: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 +/- 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. RESULTS: The VO2 peak increased 26% in the Trained patients (15.4 +/- 4.3 vs 19.4 +/- 5.5 ml/kg/min; p < or = 0.05) but did not change in the Controls (16.2 +/- 5.2 vs 16.8 +/- 2.8 ml/kg/min; p > or = 0.05). Brachial artery flow-mediated dilation (10.1% +/- 6.1% vs 9.6% +/- 6.2%) and absolute brachial diameter (0.48 +/- 0.22 vs 0.42 +/- 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5% +/- 2.8% vs 7.9% +/- 5.1%) and the absolute change in brachial diameter (0.48 +/- 0.16 vs 0.36 +/- 0.24 mm) decreased significantly (p < or = 0.05) in the Control patients. Resting norepinephrine decreased significantly (p < or = 0.05) after training (0.32 +/- 0.19 vs 0.22 +/- 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 +/- 0.17 vs 0.53 +/- 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. CONCLUSIONS: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation.
Authors: Daniel J Green; Maria T E Hopman; Jaume Padilla; M Harold Laughlin; Dick H J Thijssen Journal: Physiol Rev Date: 2017-04 Impact factor: 37.312
Authors: Gary L Pierce; Anthony J Donato; Thomas J LaRocca; Iratxe Eskurza; Annemarie E Silver; Douglas R Seals Journal: Aging Cell Date: 2011-10-17 Impact factor: 9.304
Authors: Juliana Andrade Ferreira de Souza; Bruna T S Araújo; Gustavo Henrique Correia de Lima; Armèle Dornelas de Andrade; Shirley Lima Campos; Maria Inês Remígio de Aguiar; Rodrigo Moreno Dias Carneiro; Daniella Cunha Brandão Journal: Heart Fail Rev Date: 2020-05 Impact factor: 4.214
Authors: Lindsey Anderson; Tricia T Nguyen; Christian H Dall; Laura Burgess; Charlene Bridges; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2017-04-04
Authors: Caio Victor de Sousa; Marcelo Magalhães Sales; Thiago Santos Rosa; John Eugene Lewis; Rosangela Vieira de Andrade; Herbert Gustavo Simões Journal: Sports Med Date: 2017-02 Impact factor: 11.136
Authors: Ammar W Ashor; Jose Lara; Mario Siervo; Carlos Celis-Morales; Clio Oggioni; Djordje G Jakovljevic; John C Mathers Journal: Sports Med Date: 2015-02 Impact factor: 11.136
Authors: Katrine Rolid; Arne K Andreassen; Marianne Yardley; Elisabeth Bjørkelund; Kristjan Karason; Julia P Wigh; Christian H Dall; Finn Gustafsson; Lars Gullestad; Kari Nytrøen Journal: World J Transplant Date: 2018-09-10