Improvement in lower limb vasodilatory reserve and exercise capacity in patients with chronic heart failure due to valvular heart disease

Chiba, Makoto; Nakamura, Motoyuki; Kanaya, Yoshinori; Kobayashi, Noboru; Ueshima, Kenji; Kawazoe, K; Hiramori, Katsuhiko

doi:10.1093/oxfordjournals.eurheartj.a015202

Cited by 10 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cardiopulmonary exercise test was carried out with the subject in an upright position on an electronically braked bicycle ergometer, as previously reported 10. In brief, patients warmed up at rest for three minutes on the ergometer, and then entered the work phase, starting at a rate of 10 W for three minutes.…”

Section: Methodsmentioning

confidence: 99%

Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure

Kanaya

Nakamura

Kobayashi

et al. 1999

Heart

View full text Add to dashboard Cite

Objective-To determine whether the reactive hyperaemic response of the lower limb increases with improved exercise capacity after acute supplementation with L-arginine, the precursor of nitric oxide, in patients with chronic heart failure. Methods-19 patients with chronic heart failure were enrolled in the study. Rest calf blood flow and femoral occlusion induced calf blood flow changes were measured by venous occlusion plethysmography before and after intravenous infusion of 10% L-arginine solution (5 ml/kg for 30 minutes) or placebo. Postexercise calf blood flow was also measured after the experimental infusion. During both postinfusion periods, several exercise capacity indices were determined by a symptom limited cardiopulmonary exercise test using a bicycle ergometer. Results-Baseline calf blood flow, systemic blood pressure, and heart rate showed no significant changes in either of the two experimental conditions. However, the occlusion induced blood flow response was significantly enhanced by L-arginine infusion (mean (SEM) peak flow, 19.6 (1.5) v 28.9 (3.1) ml/min/dl calf tissue; p < 0.01), but not by placebo (peak flow, 19.1 (1.4) v 20.9 (1.8) ml/min/dl calf tissue; NS). Calf blood flow response after exercise was also higher after L-arginine infusion than after placebo (peak flow, 4.8 (0.4) v 6.0 (0.8) ml/min/dl calf tissue; p < 0.05). L-arginine infusion had no significant eVect compared with placebo on exercise capacity indices such as peak oxygen uptake (17.1 (1.0) v 15.8 (1.1) ml/min/kg; NS), anaerobic threshold (10.5 (0.6) v 10.4 (0.7) ml/min/kg; NS), and exercise time (296 (23) v 283 (22) s; NS). Conclusions-Acute supplementation with the nitric oxide precursor L-arginine increased lower limb reactive hyperaemia but did not lead to any significant improvement in exercise capacity in patients with chronic heart failure. (Heart 1999;81:512-517)

show abstract

Section: Methodsmentioning

confidence: 99%

Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure

Kanaya

Nakamura

Kobayashi

et al. 1999

Heart

View full text Add to dashboard Cite

show abstract

“…Peak CBF was determined after two successive 5-minute periods of arterial occlusion, which were induced by inflating the thigh cuff to a pressure of 220 mmHg (Chiba et al 1997). A resting period of 15 minutes was permitted between the two successive ischemic periods to ensure blood flow had returned to baseline (Siggaard-Anderson 1970; Proctor et al 2005).…”

Section: Methodsmentioning

confidence: 99%

“…Immediately after the 5-minute period of arterial occlusion, 12 serial blood flow measurements were recorded over a period of 3 minutes by intermittently inflating the thigh cuff to a pressure of 80 mmHg (Marchiori et al 1994). To monitor reactive hyperemic blood flow over time, a duty cycle of 15 seconds was used (8 on, 7 off), as previously described (Chiba et al 1997). The first blood flow measurement began 7 seconds after the end of the arterial occlusion period, and peak CBF was accepted as the highest flow obtained during the successive measurements.…”

Section: Methodsmentioning

confidence: 99%

Lower limb vasodilatory capacity is not reduced in patients with moderate COPD

Sabapathy¹,

Awater²,

Schneider³

et al. 2006

International Journal of COPD

View full text Add to dashboard Cite

We compared exercise capacity (peak O2 uptake; V̇O2peak) and lower limb vasodilatory capacity in 9 patients with moderate COPD (FEV1 52.7 ± 7.6% predicted) and 9 age-matched healthy control subjects. V̇O2peak was measured via open circuit spirometry during incremental cycling. Calf blood flow (CBF) measurements were obtained at rest and after 5 minutes of ischemia using venous occlusion plethysmography. While V̇O2peak was significantly lower in the COPD patients (15.8 ± 3.5 mL·kg−1·min−1) compared with the control group (25.2 ± 3.5 mL·kg−1·min−1), there were no significant differences between groups in peak CBF or peak calf conductance measured 7 seconds post-ischemia. V̇O2peak was significantly correlated with peak CBF and peak conductance in the control group, whereas no significant relationship was found between these variables in the COPD group. However, the rate of decay in blood flow following ischemia was significantly slower (p < 0.05) for the COPD group (−0.036 ± 0.005 mL·100 mL−1·min−1·s−1) when compared with controls (−0.048 ± 0.015 mL·100 mL−1·min−1·s−1). The results suggest that the lower peak exercise capacity in patients with moderate COPD is not related to a loss in leg vasodilatory capacity.

show abstract

“…• O2 was measured during CPX as described previously 9 and the LVEF and Tei index were obtained by 2D-Echo. 10 The measurement of LVEF used a modified Simpson's method with the apical 4-chamber view and the Tei index (normal range: 0.39±0.05), defined as the sum of the isovolumetric contraction time and isovolumetric relaxation time divided by ejection time, was measured from the LV outflow and mitral inflow Doppler velocity profiles as described by Tei et al 10 In addition, the subjects were divided into 3 groups according to their Tei index before the start of exercise train- For statistical analysis, ANOVA was used and p<0.05 was regarded as significant.…”

Section: Methodsmentioning

confidence: 99%

Effects of Exercise Training on Left Ventricular Function Evaluated by the Tei Index in Patients With Myocardial Infarction

Ueshima

Suzuki

Nasu

et al. 2005

Circ J

View full text Add to dashboard Cite

everal studies have reported the influence of exercise training on left ventricular (LV) contractility in patients with myocardial infarction (MI), although consensus has not been obtained; no changes in resting contractility were observed, 1-4 improvement was achieved only in patients with cardiac dysfunction, 5 deterioration was observed only in patients with cardiac dysfunction, 6 LV ejection fraction (LVEF) during exercise improved. 7,8 The present study was conducted to investigate the influence of exercise training on LV function and exercise tolerance in patients with acute MI (AMI) using a new index of cardiac function, the Tei index. The Tei index is an echocardiographic/Doppler index of the combined LV systolic and diastolic function. We investigated the correlation between the Tei index, LVEF as a marker for systolic function, and exercise capacity in patients with AMI who were enrolled in a cardiac rehabilitation program. MethodsThe study population comprised 53 consecutive patients (36 males, 17 females; mean age: 65±10 years) admitted to hospital for AMI. Patients were excluded if they had some risks associated with exercise training, such as coronary artery disease with residual myocardial ischemia and severe aortic stenosis, if they had orthopedic or neuromuscular or if they had frequent ectopic beats or atrial fibrillation. An anterior wall infarction developed in 45% of the patients, 6% of the patients had a history of old MI and 60% of the patients underwent reperfusion therapy in the acute stage. Mean LVEF in the acute stage was 52%. According to the Killip's classification, 94% of the patients were I or II.The in-hospital and outpatient cardiac rehabilitation program for patients with AMI was either a 2-or 3-week program according to the Guideline for Rehabilitation of Cardiovascular Patients and was supported by a research grant for cardiovascular diseases (5C-3) from the Ministry of Health and Welfare from 1993 until 1995 (Director Muneyasu Saito). Exercise training, which was prescribed on the basis of 90% intensity of the anaerobic threshold, was performed 2-3 times per week for 6 months. Acutestage exercise training during admission was performed under monitoring and chronic-stage exercise therapy was continued under monitoring at the outpatient clinic or unsupervised at home. In principle, subjects maintained their medications throughout the study. Prior to participation, informed consent was obtained from each patient.Cardiopulmonary exercise testing (CPX) and 2-dimensional Doppler echocardiography (2D-Echo) were carried out at the start of the cardiac rehabilitation program and at 1, 3, and 6 months later. Peak V• O2 was measured during CPX as described previously 9 and the LVEF and Tei index were obtained by 2D-Echo. 10 The measurement of LVEF used a modified Simpson's method with the apical 4-chamber view and the Tei index (normal range: 0.39±0.05), defined as the sum of the isovolumetric contraction time and isovolumetric relaxation time divided by ejection time, was measured from...

show abstract

Improvement in lower limb vasodilatory reserve and exercise capacity in patients with chronic heart failure due to valvular heart disease

Cited by 10 publications

References 7 publications

Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure

Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure

Lower limb vasodilatory capacity is not reduced in patients with moderate COPD

Effects of Exercise Training on Left Ventricular Function Evaluated by the Tei Index in Patients With Myocardial Infarction

Contact Info

Product

Resources

About