Document Detail


The effect of physical training on hormonal status and exertional hormonal response in patients with chronic congestive heart failure.
MedLine Citation:
PMID:  10213349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Physical training improves exercise capacity in patients with chronic heart failure. It decreases plasma noradrenaline at rest, which may be prognostically favourable. The effect on atrial natriuretic peptide, another prognostic factor, and on catabolic and anabolic hormones remains unknown. Furthermore, to our knowledge, the contribution of exertional hormonal responses to the improved exercise capacity has not been evaluated. METHODS: 27 patients with stable chronic heart failure (New York Heart Association class II-III) were randomized to training (n=12) and control (n=15) groups. The training group exercised on a bicycle ergometer for 30 min three times a week for 3 months. The load corresponded to 50-60% of their peak oxygen consumption. For the next 3 months they exercised at home according to personal instructions. The control group did not change its physical activities. The levels of hormones regulating the cardiovascular system and metabolism were determined at rest and after graded maximal exercise and during exercise with constant submaximal workload. RESULTS: Submaximal exercise capacity increased significantly and peak oxygen consumption tended to improve by 12% in the training group. The plasma noradrenaline at rest tended to decrease by 19%. The plasma level of N-terminal pro atrial natriuretic peptide did not change. Serum cortisol, a catabolic hormone, was normal at baseline and remained unchanged. The serum levels of anabolic hormones, growth hormone and insulin, as well as dehydroepiandrosteronesulfate and free testosterone were within a normal range at baseline. They were not altered by training. The dehydroepiandrosteronesulfate/cortisol, and the free testosterone/cortisol ratios, reflecting anabolic/catabolic balance, did not change, either. Training resulted in a higher peak noradrenaline response during graded maximal exercise. The rise in serum cortisol during exercise tended to attenuate. CONCLUSION: Physical training, which improves exercise capacity, does not have an unfavourable effect on anabolic/catabolic balance or neurohumoral activation in patients with congestive heart failure. It decreases plasma noradrenaline at rest. Minor changes in hormonal responses during exercise emerged after physical training which unlikely contribute to the improved exercise capacity.
Authors:
K Kiilavuori; H Näveri; H Leinonen; M Härkönen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  20     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-08     Completed Date:  1999-06-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  456-64     Citation Subset:  IM    
Affiliation:
Department of Medicine, Helsinki University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Natriuretic Factor / blood
Biological Markers / blood
Energy Metabolism
Exercise / physiology*
Exercise Test
Female
Follow-Up Studies
Heart Failure / blood*
Hormones / blood*
Humans
Hydrocortisone / blood
Male
Middle Aged
Norepinephrine / blood
Oxygen Consumption
Physical Endurance / physiology*
Prognosis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Hormones; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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