Dietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fraction

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dc.citation.issue1
dc.citation.volume312
dc.contributor.authorHirai, Daniel Müller [UNIFESP]
dc.contributor.authorZelt, Joel T.
dc.contributor.authorJones, Joshua H.
dc.contributor.authorCastanhas, Luiza G.
dc.contributor.authorBentley, Robert F.
dc.contributor.authorEarle, Wendy
dc.contributor.authorStaples, Patti
dc.contributor.authorTschakovsky, Michael E.
dc.contributor.authorMcCans, John
dc.contributor.authorO'Donnell, Denis E.
dc.contributor.authorNeder, J. Alberto
dc.coverageBethesda
dc.date.accessioned2020-07-31T12:46:49Z
dc.date.available2020-07-31T12:46:49Z
dc.date.issued2017
dc.description.abstractEndothelial 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, respectivelyen
dc.description.abstractP < 0.05). There was no significant difference in the primary outcome of time to exercise intolerance between nitrate and placebo (495 +/- 53 vs. 489 +/- 58 s, respectivelyen
dc.description.abstractP > 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.en
dc.description.affiliationQueens Univ, Dept Med, Div Respirol, Lab Clin Exercise Physiol, Kingston, ON, Canada
dc.description.affiliationUniv Fed Sao Paulo, Dept Med, Div Resp, Pulm Funct & Clin Exercise Physiol Unit, Sao Paulo, Brazil
dc.description.affiliationQueens Univ, Sch Kinesiol & Hlth Studies, Human Vasc Control Lab, Kingston, ON, Canada
dc.description.affiliationQueens Univ, Dept Med, Div Cardiol, Kingston, ON, Canada
dc.description.affiliationQueens Univ, Dept Med, Div Respirol, Resp Investigat Unit, Kingston, ON, Canada
dc.description.affiliationUnifespDepartment of Medicine, Respiratory Division, Pulmonary Function and Clinical Exercise Physiology Unit, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipSenate Advisory Research Committee (SARC) Postdoctoral Fellow Support Program
dc.description.sponsorshipDepartment of Medicine, Queen's University
dc.format.extentR13-R22
dc.identifierhttp://dx.doi.org/10.1152/ajpregu.00263.2016
dc.identifier.citationAmerican Journal Of Physiology-Regulatory Integrative And Comparative Physiology. Bethesda, v. 312, n. 1, p. R13-R22, 2017.
dc.identifier.doi10.1152/ajpregu.00263.2016
dc.identifier.issn0363-6119
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56378
dc.identifier.wosWOS:000395715600003
dc.language.isoeng
dc.publisherAmer Physiological Soc
dc.relation.ispartofAmerican Journal Of Physiology-Regulatory Integrative And Comparative Physiology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectblood pressureen
dc.subjectnitriteen
dc.subjectnitric oxideen
dc.subjectoxygen consumptionen
dc.subjectskeletal muscleen
dc.titleDietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fractionen
dc.typeinfo:eu-repo/semantics/article
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