Oral L-arginine supplementation significantly decreased mean pulmonary arterial pressure by 9% (p<0.05) and pulmonary vascular resistance by 16% (p<0.05) compared to placebo.
RCT (n=19)
Does oral L-arginine improve hemodynamics and exercise capacity in patients with primary or precapillary secondary pulmonary hypertension?
Short-term oral L-arginine supplementation significantly improves pulmonary hemodynamics and exercise capacity in patients with precapillary pulmonary hypertension.
p-value: p=<0.05
We sought to assess the effects of oral supplementation of L-arginine, the precursor of nitric oxide (NO), on hemodynamics and exercise capacity in patients with pulmonary hypertension. Acute hemodynamic responses to oral L-arginine (0.5 g/10 kg body weight) or placebo were examined in 19 patients with primary or precapillary secondary pulmonary hypertension. Cardiopulmonary exercise tests were performed to measure peak oxygen consumption (peak V O(2)) and the ventilatory response to carbon dioxide production (V E-V CO(2) slope) before and 1 wk after treatment with L-arginine (1.5 g/10 kg body weight/d) or placebo. Oral supplementation of L-arginine significantly increased plasma L-citrulline, which indicated enhancement of NO production. Supplemental L-arginine produced a 9% decrease in mean pulmonary arterial pressure (53 +/- 4 to 48 +/- 4 mm Hg, p < 0.05) and a 16% decrease in pulmonary vascular resistance (14.8 +/- 1.5 to 12.4 +/- 1.4 Wood units, p < 0.05). L-arginine modestly decreased mean systemic arterial pressure (92 +/- 4 to 87 +/- 3 mm Hg, p < 0.05). A 1-wk supplementation of L-arginine resulted in a slight increase in peak V O(2) (831 +/- 88 to 896 +/- 92 ml/min, p < 0.05) and a significant decrease in the V E- V CO(2) slope (43 +/- 4 to 37 +/- 3, p < 0.05) without significant systemic hypotension. Hemodynamics and exercise capacity remained unchanged during placebo administration. These results suggest that oral supplementation of L-arginine may have beneficial effects on hemodynamics and exercise capacity in patients with precapillary pulmonary hypertension.
Nagaya et al. (Thu,) conducted a rct in precapillary pulmonary hypertension (n=19). L-arginine vs. Placebo was evaluated on mean pulmonary arterial pressure (p=<0.05). Oral L-arginine supplementation significantly decreased mean pulmonary arterial pressure by 9% (p<0.05) and pulmonary vascular resistance by 16% (p<0.05) compared to placebo.