Document Detail

L-arginine supplementation improves exercise capacity after a heart transplant.
MedLine Citation:
PMID:  20200265     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Endothelial dysfunction is associated with the decreased exercise capacity observed in heart-transplant (HTx) recipients. L-arginine supplementation (LAS) stimulates the nitric oxide (NO) pathway and restores endothelial function. OBJECTIVE: We compared exercise capacity in healthy subjects and HTx patients and investigated whether chronic LAS might improve exercise capacity and NO/endothelin balance after an HTx. DESIGN: Clinical, echocardiographic, and exercise characteristics were measured in 11 control subjects and 22 HTx recipients. In a prospective, double-blind study, the 22 HTx recipients performed a 6-min exercise [6-min-walk test (6MWT)] and a maximal bicycle exercise test before and after a 6-wk period of placebo intake or LAS. Endothelial function was measured by analyzing blood NO metabolites, endothelin, and the resulting NO/endothelin balance. RESULTS: Exercise capacity decreased after transplantation. Unlike with the placebo intake, 6 wk of LAS improved quality of life in HTx recipients (mean +/- SEM Minnesota Score: from 15.3 +/- 1.3 to 10.6 +/- 1.1; P < 0.001) and their submaximal exercise capacity. The distance walked during the 6MWT increased (from 525 +/- 20 to 580 +/- 20 m; P = 0.002), and the ventilatory threshold during the incremental test was delayed by 1.2 min (P = 0.01). Central factors such as resting stroke volume, systolic pulmonary arterial pressure, cardiac systolodiastolic functions, and heart-rate reserve were not modified, but LAS significantly increased the NO:endothelin ratio (from 2.49 +/- 0.38 to 3.31 +/- 0.39; P = 0.03). CONCLUSION: Oral LAS may be a useful adjuvant therapeutic to improve quality of life and exercise tolerance in HTx recipients.
St?phane Doutreleau; Olivier Rouyer; Paola Di Marco; Evelyne Lonsdorfer; Ruddy Richard; Fran?ois Piquard; Bernard Geny
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Publication Detail:
Type:  Journal Article     Date:  2010-03-03
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  91     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1261-7     Citation Subset:  AIM; IM    
Medicine Faculty, Physiology Institute, Strasbourg, France.
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MeSH Terms
Arginine / administration & dosage,  blood,  therapeutic use*
Blood Pressure / drug effects
Cyclosporine / blood
Dietary Supplements
Double-Blind Method
Endothelin-1 / blood
Endothelins / blood
Exercise Test / methods
Exercise Tolerance / physiology*
Heart Rate / drug effects
Heart Transplantation / physiology*
Immunosuppressive Agents / blood,  therapeutic use
Middle Aged
Nitric Oxide / blood
Patient Selection
Pulmonary Artery / drug effects,  physiology,  physiopathology
Quality of Life
Reg. No./Substance:
0/Endothelin-1; 0/Endothelins; 0/Immunosuppressive Agents; 0/Placebos; 10102-43-9/Nitric Oxide; 59865-13-3/Cyclosporine; 74-79-3/Arginine

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