Relationship between exercise intervention and NO pathway in patients with heart failure with preserved ejection fraction |
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| Authors: | Flavia Baldassarri Edzard Schwedhelm Dorothee Atzler Rainer H Böger Kathrin Cordts Bernhard Haller |
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| Institution: | 1. Department of Prevention, Rehabilitation and Sports Medicine, Technische Universit?t München, Munich, Germany;2. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany;3. baldassarri@sport.med.tum.de;5. Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;6. DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany;7. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany;8. Institute for Cardiovascular Prevention (IPEK), Klinikum der Universit?t München, Ludwig-Maximilians-University Munich, Munich, Germany;9. Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University Munich, Munich, Germany;10. Institute of Medical Statistics and Epidemiology, Technische Universit?t München, Munich, Germany |
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| 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  | |
| Keywords: | HFpEF exercise intervention ADMA SDMA l-homoarginine" target="_blank">l-homoarginine l-arginine" target="_blank">l-arginine |
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