| Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. | |
| | |
MedLine Citation:
|
PMID: 20430934 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Attenuated peripheral perfusion in patients with advanced chronic heart failure (CHF) is partially the result of endothelial dysfunction. This has been causally linked to an impaired endogenous regenerative capacity of circulating progenitor cells (CPC). The aim of this study was to elucidate whether exercise training (ET) affects exercise intolerance and left ventricular (LV) performance in patients with advanced CHF (New York Heart Association class IIIb) and whether this is associated with correction of peripheral vasomotion and induction of endogenous regeneration. METHODS AND RESULTS: Thirty-seven patients with CHF (LV ejection fraction 24+/-2%) were randomly assigned to 12 weeks of ET or sedentary lifestyle (control). At the beginning of the study and after 12 weeks, maximal oxygen consumption (Vo(2)max) and LV ejection fraction were determined; the number of CD34(+)/KDR(+) CPCs was quantified by flow cytometry and CPC functional capacity was determined by migration assay. Flow-mediated dilation was assessed by ultrasound. Capillary density was measured in skeletal muscle tissue samples. In advanced CHF, ET improved Vo(2)max by +2.7+/-2.2 versus -0.8+/-3.1 mL/min/kg in control (P=0.009) and LV ejection fraction by +9.4+/-6.1 versus -0.8+/-5.2% in control (P<0.001). Flow-mediated dilation improved by +7.43+/-2.28 versus +0.09+/-2.18% in control (P<0.001). ET increased the number of CPC by +83+/-60 versus -6+/-109 cells/mL in control (P=0.014) and their migratory capacity by +224+/-263 versus -12+/-159 CPC/1000 plated CPC in control (P=0.03). Skeletal muscle capillary density increased by +0.22+/-0.10 versus -0.02+/-0.16 capillaries per fiber in control (P<0.001). CONCLUSIONS: Twelve weeks of ET in patients with advanced CHF is associated with augmented regenerative capacity of CPCs, enhanced flow-mediated dilation suggestive of improvement in endothelial function, skeletal muscle neovascularization, and improved LV function. Clinical Trial Registration- http://www.clinicaltrials.gov. Unique Identifier: NCT00176384. |
| | |
Authors:
|
Sandra Erbs; Robert Höllriegel; Axel Linke; Ephraim B Beck; Volker Adams; Stephan Gielen; Sven Möbius-Winkler; Marcus Sandri; Nicolle Kränkel; Rainer Hambrecht; Gerhard Schuler |
Related Documents
:
|
10197224 - Effects of severity of long-standing congestive heart failure on pulmonary function. 19318954 - Exercise capacity in chronic heart failure patients is related to active gene transcrip... 16679264 - Reduced rate of alveolar-capillary recruitment and fall of pulmonary diffusing capacity... 3913604 - Bed rest and increased diuretic treatment in chronic congestive heart failure. 3224454 - Differences in composition of sweat induced by thermal exposure and by running exercise. 16380834 - Protein synthesis-dependent reactivation of a contextual conditioned reflex in the comm... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-04-29 |
Journal Detail:
|
Title: Circulation. Heart failure Volume: 3 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-21 Completed Date: 2010-08-10 Revised Date: 2011-10-27 |
Medline Journal Info:
|
Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
|
Languages: eng Pagination: 486-94 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. Sandra.Erbs@medizin.uni-leipzig.de |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00176384 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Chronic Disease Endothelium, Vascular / physiology* Exercise Therapy / methods* Exercise Tolerance / physiology Female Follow-Up Studies Heart Failure / diagnosis, rehabilitation* Humans Leg / blood supply Male Middle Aged Muscle, Skeletal / blood supply, physiology Oxidative Stress / physiology Prospective Studies Recovery of Function Regional Blood Flow / physiology Risk Assessment Sedentary Lifestyle Severity of Illness Index Stroke Volume / physiology* Time Factors Treatment Outcome Vascular Resistance / physiology Vasomotor System / physiology Ventricular Function, Left / physiology* Ventricular Remodeling / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The quality, safety and content of telephone and face-to-face consultations: a comparative study.
Next Document: Advances in understanding the molecular basis of FXTAS.