Flavia Baldassarri1,2, Edzard Schwedhelm3,4, Dorothee Atzler2,5,6, Rainer H Böger3,4, Kathrin Cordts3,4, Bernhard Haller7, Axel Pressler1, Stephan Müller1, Christiane Suchy1, Rolf Wachter8,9, Hans-Dirk Düngen10,11, Gerd Hasenfuss8,9, Burkert Pieske10,11,12, Martin Halle1,2, Frank Edelmann8,9,10,11, André Duvinage1,2. 1. a Department of Prevention, Rehabilitation and Sports Medicine , Technische Universität München , Munich , Germany. 2. b DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich , Germany. 3. c Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf , Hamburg , Germany. 4. d DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck , Hamburg , Germany. 5. e Institute for Cardiovascular Prevention (IPEK), Klinikum der Universität München, Ludwig-Maximilians-University Munich , Munich , Germany. 6. f Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University Munich , Munich , Germany. 7. g Institute of Medical Statistics and Epidemiology, Technische Universität München , Munich , Germany. 8. h Department of Cardiology and Pneumology , University of Göttingen Medical Center , Göttingen , Germany. 9. i DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen , Göttingen , Germany. 10. j Department of Cardiology , Charite´ - Universita¨tsmedizin Berlin , Berlin , Germany. 11. k DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin , Germany. 12. l Department of Cardiology , Deutsches Herzzentrum Berlin (DHZB) , Berlin , Germany.
Abstract
OBJECTIVE: Elevated levels of arginine derivatives in the NO pathway, such as asymmetric dimethylarginine (ADMA), are related to disease severity and reduced exercise capacity in heart failure (HF). We investigated the influence of exercise intervention on these parameters and on L-arginine (L-Arg) and L-homoarginine (L-hArg) in HF with preserved ejection fraction (HFpEF) patients. MATERIAL AND METHODS:Sixty-two patients (65 ± 6 years) were included in this analysis and randomized to supervised endurance/resistance training (ET) or to usual care (UC). EDTA-plasma was analysed for NO metabolites. RESULTS: There were baseline associations for adjusted values of maximum workload with ADMA (r= -0.322, p = 0.028) and L-Arg/ADMA ratio (r = 0.331, p = 0.015), and for the 6-min walk test (6MWT) with ADMA (r= -0.314, p = 0.024) and L-Arg/ADMA ratio (r = 0.346, p = 0.015). No significant differences between UC and ET changes of NO parameters were observed at 3-month follow-up. Higher L-hArg levels were associated with a greater improvement in peak oxygen uptake (peak [Formula: see text]O2) at follow-up: 3.4 ± 2.8 vs. 1.1 ± 2.9 mL/min/kg (p = 0.005). CONCLUSIONS:Exercise intervention did not influence NO parameters in HFpEF patients, but L-hArg was related to change in peak [Formula: see text]O2.
RCT Entities:
OBJECTIVE: Elevated levels of arginine derivatives in the NO pathway, such as asymmetric dimethylarginine (ADMA), are related to disease severity and reduced exercise capacity in heart failure (HF). We investigated the influence of exercise intervention on these parameters and on L-arginine (L-Arg) and L-homoarginine (L-hArg) in HF with preserved ejection fraction (HFpEF) patients. MATERIAL AND METHODS: Sixty-two patients (65 ± 6 years) were included in this analysis and randomized to supervised endurance/resistance training (ET) or to usual care (UC). EDTA-plasma was analysed for NO metabolites. RESULTS: There were baseline associations for adjusted values of maximum workload with ADMA (r= -0.322, p = 0.028) and L-Arg/ADMA ratio (r = 0.331, p = 0.015), and for the 6-min walk test (6MWT) with ADMA (r= -0.314, p = 0.024) and L-Arg/ADMA ratio (r = 0.346, p = 0.015). No significant differences between UC and ET changes of NO parameters were observed at 3-month follow-up. Higher L-hArg levels were associated with a greater improvement in peak oxygen uptake (peak [Formula: see text]O2) at follow-up: 3.4 ± 2.8 vs. 1.1 ± 2.9 mL/min/kg (p = 0.005). CONCLUSIONS: Exercise intervention did not influence NO parameters in HFpEF patients, but L-hArg was related to change in peak [Formula: see text]O2.
Authors: Wojciech Wołyniec; Katarzyna Kasprowicz; Joanna Giebułtowicz; Natalia Korytowska; Katarzyna Zorena; Maria Bartoszewicz; Patrycja Rita-Tkachenko; Marcin Renke; Wojciech Ratkowski Journal: Int J Environ Res Public Health Date: 2019-10-28 Impact factor: 3.390