Key result
Intra-arterial infusion of L-arginine significantly increased maximum forearm blood flow after handgrip exercise in patients with heart failure (from 15.2 to 24.7; p<0.01).
Why the study?
Does intra-arterial infusion of L-arginine improve exercise-induced vasodilation of the forearm in patients with heart failure?
Does intra-arterial infusion of L-arginine improve exercise-induced vasodilation of the forearm in patients with heart failure?
Absolute Event Rate: 24.7% vs 15.2%
p-value: p=<0.01
Intra-arterial L-arginine improves exercise-induced vasodilation in heart failure patients, highlighting the role of endothelial dysfunction in impaired vasodilation for this population.
L-arginine may enhance exercise vasodilation in heart failure; leaves open whether supplementation improves outcomes.
To determine whether L-arginine, a precursor of nitric oxide, can improve exercise-induced vasodilation of the forearm in patients with heart failure, we measured forearm blood flow in 9 patients with heart failure and in 7 age-matched control subjects before and after intra-arterial infusion of L-arginine. Resting forearm blood flow was significantly lower in patients with heart failure than in control subjects (2.34 +/- 0.85 (SD) vs 4.76 +/- 0.77 ml/min per 100 ml, p < 0.001). Endothelium-dependent vasodilation induced by acetylcholine was attenuated in patients with heart failure (p < 0.05). Exercise-induced vasodilation after handgrip exercise was significantly lower in patients with heart failure (p < 0.05). Intra-arterial infusion of L-arginine did not change basal forearm blood flow but significantly augmented acetylcholine-induced vasodilation in both patients with heart failure and control subjects (p < 0.05). Although L-arginine did not affect maximum forearm blood flow after handgrip exercise in control subjects (before, 26.2 +/- 13.5; after, 25.7 +/- 14.3; p = NS), it was increased in patients with heart failure (from 15.2 +/- 4.9 to 24.7 +/- 14.6, p < 0.01). The finding that L-arginine increased both acetylcholine- and exercise-induced vasodilation in patients with heart failure suggests that endothelial dysfunction might play an important role in impaired exercise-induced vasodilation in patients with heart failure.
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Kubota et al. (1997) studied Heart failure (n=16). Intra-arterial infusion of L-arginine vs. Baseline (before infusion) and age-matched controls was evaluated on Maximum forearm blood flow after handgrip exercise (p=<0.01). Intra-arterial infusion of L-arginine significantly increased maximum forearm blood flow after handgrip exercise in patients with heart failure (from 15.2 to 24.7; p<0.01).
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