Dietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fraction
Hirai DM, Zelt JT, Jones JH, Castanhas LG, Bentley RF, Earle W, Staples P, Tschakovsky ME, McCans J, O'Donnell DE, Neder JA
American journal of physiology. Regulatory, integrative and comparative physiology · 56 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- John A. Alexander Stewart Fellowship, Dept. of Medicine, Queen's University
- Universidad u hospital
- Senate Advisory Research Committee Postdoctoral Fellow Support Program, Dept. of Medicine, Queen's University
Según 2 financiadores declarados.
Publicación
- Publicado
- 2016-10-27 · Am J Physiol Regul Integr Comp Physiol · vol. 312 · número 1 · págs. R13–R22
- Editorial
- American Physiological Society
- Citado
- 67 citas · más que el 100% de estudios similares · 23.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 64 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · OTHER-OA
- Áreas de investigación
- Cardiovascular and exercise physiology · Heart Rate Variability and Autonomic Control · Cardiovascular Function and Risk Factors
- Palabras clave
- Medicine, Cardiology, Ejection fraction, Heart failure, Internal medicine, Stroke volume, Hemodynamics, Crossover study, Blood pressure, Heart rate, Cardiac output, Nitric oxide, Placebo, Oxygenation, Anesthesia
- MeSH
- humans, ventricular dysfunction, left, nitrates, stroke volume, exercise test, treatment outcome, double-blind method, exercise tolerance, dietary supplements, middle aged, male, heart failure
11 autores
- Daniel M. Hirai🇨🇦🇧🇷 · autor de correspondenciaQueen's University; Universidade Federal de São Paulo
- Joel T. Zelt🇨🇦Queen's University
- Joshua H. Jones🇨🇦Queen's University
- Luiza G. Castanhas🇨🇦Queen's University
- Robert Francis Bentley🇨🇦Queen's University
- Wendy Earle🇨🇦Queen's University
- Patti Staples🇨🇦Queen's University
- Michael E. Tschakovsky🇨🇦Queen's University
- John McCans🇨🇦Queen's University
- Denis E. O’Donnell🇨🇦Queen's University
- José Alberto Neder🇨🇦Queen's University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Endothelial dysfunction and reduced nitric oxide (NO) signaling are key abnormalities leading to skeletal muscle oxygen delivery-utilization mismatch and poor physical capacity in patients with heart failure with reduced ejection fraction (HFrEF). Oral inorganic nitrate supplementation provides an exogenous source of NO that may enhance locomotor muscle function and oxygenation with consequent improvement in exercise tolerance in HFrEF. Thirteen patients (left ventricular ejection fraction ≤40%) were enrolled in a double-blind, randomized crossover study to receive concentrated nitrate-rich (nitrate) or nitrate-depleted (placebo) beetroot juice for 9 days. Low- and high-intensity constant-load cardiopulmonary exercise tests were performed with noninvasive measurements of central hemodynamics (stroke volume, heart rate, and cardiac output via impedance cardiography), arterial blood pressure, pulmonary oxygen uptake, quadriceps muscle oxygenation (near-infrared spectroscopy), and blood lactate concentration. Ten patients completed the study with no adverse clinical effects. Nitrate-rich supplementation resulted in significantly higher plasma nitrite concentration compared with placebo (240 ± 48 vs. 56 ± 8 nM, respectively; P 0.05). Similarly, there were no significant differences in central hemodynamics, arterial blood pressure, pulmonary oxygen uptake kinetics, skeletal muscle oxygenation, or blood lactate concentration from rest to low- or high-intensity exercise between conditions. Oral inorganic nitrate supplementation with concentrated beetroot juice did not present with beneficial effects on central or peripheral components of the oxygen transport pathway thereby failing to improve exercise tolerance in patients with moderate HFrEF.
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