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 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- University or hospital
- John A. Alexander Stewart Fellowship, Dept. of Medicine, Queen's University
- University or hospital
- Senate Advisory Research Committee Postdoctoral Fellow Support Program, Dept. of Medicine, Queen's University
Based on 2 listed funder(s).
Publication
- Published
- 2016-10-27 · Am J Physiol Regul Integr Comp Physiol · vol. 312 · issue 1 · pp. R13–R22
- Publisher
- American Physiological Society
- Cited
- 67 citations · more than 100% of similar papers · 23.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 64 works
- Access
- Open access (repository copy) · OTHER-OA
- Research areas
- Cardiovascular and exercise physiology · Heart Rate Variability and Autonomic Control · Cardiovascular Function and Risk Factors
- Keywords
- 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 authors
From CA, BR
- Daniel M. Hirai · correspondingQueen's University; Universidade Federal de São Paulo
- Joel T. ZeltQueen's University
- Joshua H. JonesQueen's University
- Luiza G. CastanhasQueen's University
- Robert Francis BentleyQueen's University
- Wendy EarleQueen's University
Abstract
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.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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