Affiliation:
1. From the Med Klinik III, University of Freiburg (Germany).
Abstract
Background
Chronic heart failure is associated with endothelial dysfunction including impaired endothelium-mediated, flow-dependent dilation (FDD). Since endothelial function is thought to play an important role in coordinating tissue perfusion and modulating arterial compliance, interventions to improve endothelial dysfunction are imperative.
Methods and Results
To assess the potential of physical training to restore FDD, 12 patients with chronic heart failure were studied and compared with FDD of 7 age-matched normal subjects. With a recently developed high-resolution ultrasound system, diameters of radial artery were measured at rest, during reactive hyperemia (with increased flow causing endothelium-mediated dilation), and during sodium nitroprusside, causing endothelium-independent dilation. Determination of FDD was repeated after intra-arterial infusion of
N
G
-monomethyl-
l
-arginine (L-NMMA, 7 μmol/min) to inhibit endothelial synthesis and release of nitric oxide. The protocol was performed at baseline, after 4 weeks of daily handgrip training, and 6 weeks after cessation of the training program. FDD was impaired in heart failure patients compared with normal subjects. L-NMMA attenuated FDD, indicating that the endothelial release of nitric oxide is involved in FDD. Physical training restored FDD in patients with heart failure. In particular, the portion of FDD inhibited by L-NMMA (representing FDD mediated by nitric oxide) was significantly higher after physical training (8-minute occlusion: 8.0±1% versus 5.4±0.9%;
P
<.05; normal subjects: 9.2±1%).
Conclusions
These results indicate that physical training restores FDD in patients with chronic heart failure, possibly by enhanced endothelial release of nitric oxide.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference28 articles.
1. Alterations in vasomotor tone in congestive heart failure
2. St Cyres lecture. Endothelium in control.
3. Endothelial function in chronic congestive heart failure
4. Hayoz D Drexler H Münzel T Hornig B Zeiher A Just H Brunner HR Zelis R. Flow-mediated arteriolar dilation is abnormal in congestive heart failure. Circulation . 1993;87(suppl VII):VII-92-VII-96.
Cited by
510 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献