Key result
Intensive physical training for 8 weeks prevented the decrease in urinary nitrate elimination seen with usual care (1.39 vs 1.03 mmol/24 hours) in patients with CHF after myocardial infarction.
Why the study?
Does intensive physical training improve urinary nitrate elimination and plasma ET-1 levels in patients with CHF after acute myocardial infarction?
RCT (n=17)
Does intensive physical training improve urinary nitrate elimination and plasma ET-1 levels in patients with CHF after acute myocardial infarction?
Intensive physical training over 8 weeks prevents the decline in urinary nitrate elimination in patients with CHF post-MI, suggesting improved endothelial vasodilator function.
Answers are grounded in this paper and cite their sources.
Supports intensive exercise training to preserve endothelial function in post-MI CHF; extends RCT evidence on vascular benefits beyond aerobic gains.
BACKGROUND: Congestive heart failure (CHF) is associated with increased peripheral vascular resistance. Exercise-induced shear stress may release endothelial relaxing factors, such as nitric oxide (NO), and inhibit the production of vasoconstrictors such as endothelin-1 (ET-1) thereby modulating vascular tone. We examined the effect of intensive training on ET-1 plasma concentrations and NO-metabolite elimination in patients with CHF after acute myocardial infarction. METHODS: Seventeen patients with CHF after a myocardial infarction were randomized to an exercise group (n = 9), who performed physical training for 8 weeks, or a control group (n = 8) who received usual care. A physical examination, pulmonary function test, and a maximum exercise test were performed, and 24-hour urinary nitrate elimination and ET-1 in plasma were determined before and at the end of the study period. RESULTS: Maximal oxygen uptake remained unchanged in controls (17.9 +/- 1.4 to 18.1 +/- 1.5 mL/(kg min) but increased in the exercise group (from 20.4 +/- 0.75 to 26.7 +/- 1.4 mL/(kg min). After 8 weeks the urinary nitrate elimination in controls was significantly decreased (1.25 +/- 0.20 to 1.03 +/- 0.22 mmol/24 hours; P < 0.001), while it was unchanged in the exercise group (1.26 +/- 0.23 to 1.39 +/- 0.28; P = 0.71). Plasma ET-1 levels did not change after 8 weeks (7.87 +/- 0.62 versus 7.57 +/- 0.75 and 7.13 +/- 0.6 versus 7.35 +/- 0.7 pg/mL for control and exercise groups, respectively). CONCLUSION: In patients with CHF after acute myocardial infarction nitrate elimination decreases over the subsequent 2 months. This trend was reversed by training. Because nitrate elimination mirrors endogenous NO production, these results suggest that training may positively influence endothelial vasodilator function.
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gh et al. (1998) conducted an RCT in Congestive heart failure after acute myocardial infarction (n=17). Intensive physical training vs. Usual care was evaluated on Urinary nitrate elimination at 8 weeks. Intensive physical training for 8 weeks prevented the decrease in urinary nitrate elimination seen with usual care (1.39 vs 1.03 mmol/24 hours) in patients with CHF after myocardial infarction.
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