© 2005 European Society of Cardiology
Home-based exercise training modulates pro-oxidant substrates in patients with chronic heart failure
a Cardiac Medicine, Royal Brompton Hospital and NHLI London, UK
b Herzzentrum der Universität Leipzig Leipzig, Germany
c Cardiac Medicine, University of Hull UK
d Clinical Pharmacology, University of Hamburg Germany
e University of Sydney Australia
* Corresponding author. Herzzentrum der Universität Leipzig, Oberarzt der Abetilung fur Innere Medizin/Kardiologie, Strümpellstr. 39, 04289 Leipzig, Germany. Tel.: +49 341 865 0; fax: +49 341 865 1461. E-mail address: j.niebauer{at}medizin.uni-leipzig.de
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Abstract |
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Background: In chronic heart failure, oxidative stress is thought to lead to endothelial dysfunction. In this study, we assessed the effect of home-based exercise training on variables of the NO and purine pathways.
Methods and results: Eighteen patients and nine controls were randomly assigned in cross-over design to 8 weeks of exercise training (5 days/week, submaximal bicycle ergometer training, 30 min/day; calisthenics 9 min/day) and 8 weeks of sedentary lifestyle. Hypoxanthine, xanthine, L-arginine, asymmetric dimethylarginine (ADMA), symmetric DMA (SDMA) and nitrite were measured. In patients, exercise training led to an increase in peak VO2 (p<0.003). At baseline hypoxanthine—a pro-oxidant substrate and marker of hypoxia—was higher in patients than in controls (24.6±4.3 vs. 11.9±4.2 µmol/l; p<0.05). After training there was a reduction in hypoxanthine (p<0.01). Nitrite levels were lower in patients (416±31 µmol/l) than in healthy controls (583±35 µmol/l, p<0.001). Although nitrite levels were highest after exercise, the changes did not reach statistical significance (p=n.s.). L-Arginine, ADMA, and SDMA levels were not different between groups and were not altered by exercise training.
Conclusions: Chronic heart failure is associated with increased levels of hypoxanthine and decreased levels of nitrite. This imbalance can be beneficially modulated by chronic home-based exercise training.
Key Words: Heart failure • Exercise • Nitric oxide • Hypoxanthine
Received March 22, 2004; Revised April 25, 2004; Accepted June 8, 2004
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