Tags

Type your tag names separated by a space and hit enter

Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
J Am Coll Cardiol 2013; 62(7):584-92JACC

Abstract

OBJECTIVES

The study sought to evaluate the effects of endurance exercise training (ET) on endothelial-dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness, and their potential contributions to the training-related increase in peak exercise oxygen consumption (Vo2) in older patients with heart failure with preserved ejection fraction (HFPEF).

BACKGROUND

Elderly HFPEF patients have severely reduced peak Vo2, which improves with ET, however, the mechanisms of this improvement are unclear. FMD and arterial distensibility are critical components of the exercise response and are reduced with aging. However, it is unknown whether these improve with ET in elderly HFPEF or contribute to the training-related improvement in peak Vo2.

METHODS

A total of 63 HFPEF patients (age 70 ± 7 years) were randomized to 16 weeks of ET (walking, arm and leg ergometry, n = 32) or attention control (CT) (n = 31). Peak Vo2, brachial artery FMD in response to cuff ischemia, carotid artery distensibility by high-resolution ultrasound, left ventricular function, and quality of life were measured at baseline and follow-up.

RESULTS

ET increased peak Vo2 (ET: 15.8 ± 3.3 ml/kg/min vs. CT: 13.8 ± 3.1 ml/kg/min, p = 0.0001) and quality of life. However, brachial artery FMD (ET: 3.8 ± 3.0% vs. CT: 4.3 ± 3.5%, p = 0.88), and carotid arterial distensibility (ET: 0.97 ± 0.56 vs. CT: 1.07 ± 0.34 × 10(-3) mm·mm Hg(-2); p = 0.65) were unchanged. Resting left ventricular systolic and diastolic function were unchanged by ET.

CONCLUSIONS

In elderly HFPEF patients, 16 weeks of ET improved peak Vo2 without altering endothelial function or arterial stiffness. This suggests that other mechanisms, such as enhanced skeletal muscle perfusion and/or oxygen utilization, may be responsible for the ET-mediated increase in peak Vo2 in older HFPEF patients. (Prospective Aerobic Reconditioning Intervention Study [PARIS]; NCT01113840).

Authors+Show Affiliations

Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157-1045, USA. dkitzman@wfubmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23665370

Citation

Kitzman, Dalane W., et al. "Effect of Endurance Exercise Training On Endothelial Function and Arterial Stiffness in Older Patients With Heart Failure and Preserved Ejection Fraction: a Randomized, Controlled, Single-blind Trial." Journal of the American College of Cardiology, vol. 62, no. 7, 2013, pp. 584-92.
Kitzman DW, Brubaker PH, Herrington DM, et al. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol. 2013;62(7):584-92.
Kitzman, D. W., Brubaker, P. H., Herrington, D. M., Morgan, T. M., Stewart, K. P., Hundley, W. G., ... Haykowsky, M. J. (2013). Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. Journal of the American College of Cardiology, 62(7), pp. 584-92. doi:10.1016/j.jacc.2013.04.033.
Kitzman DW, et al. Effect of Endurance Exercise Training On Endothelial Function and Arterial Stiffness in Older Patients With Heart Failure and Preserved Ejection Fraction: a Randomized, Controlled, Single-blind Trial. J Am Coll Cardiol. 2013 Aug 13;62(7):584-92. PubMed PMID: 23665370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. AU - Kitzman,Dalane W, AU - Brubaker,Peter H, AU - Herrington,David M, AU - Morgan,Timothy M, AU - Stewart,Kathryn P, AU - Hundley,W Gregory, AU - Abdelhamed,Abdelhamed, AU - Haykowsky,Mark J, Y1 - 2013/05/09/ PY - 2012/10/23/received PY - 2013/04/05/revised PY - 2013/04/08/accepted PY - 2013/5/14/entrez PY - 2013/5/15/pubmed PY - 2013/11/16/medline KW - A-Vo(2)Diff KW - B-type natriuretic peptide KW - BNP KW - CT KW - ET KW - FMD KW - HF KW - HFPEF KW - HFREF KW - LV KW - QOL KW - RER KW - Vo(2) KW - Vo(2)peak KW - aging KW - arteriovenous oxygen difference KW - attention control KW - exercise KW - exercise training KW - flow-mediated arterial dilation KW - heart failure KW - heart failure with preserved ejection fraction KW - heart failure with reduced ejection fraction KW - left ventricular KW - oxygen consumption KW - peak exercise oxygen uptake KW - preserved ejection fraction KW - quality of life KW - respiratory exchange ratio SP - 584 EP - 92 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 62 IS - 7 N2 - OBJECTIVES: The study sought to evaluate the effects of endurance exercise training (ET) on endothelial-dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness, and their potential contributions to the training-related increase in peak exercise oxygen consumption (Vo2) in older patients with heart failure with preserved ejection fraction (HFPEF). BACKGROUND: Elderly HFPEF patients have severely reduced peak Vo2, which improves with ET, however, the mechanisms of this improvement are unclear. FMD and arterial distensibility are critical components of the exercise response and are reduced with aging. However, it is unknown whether these improve with ET in elderly HFPEF or contribute to the training-related improvement in peak Vo2. METHODS: A total of 63 HFPEF patients (age 70 ± 7 years) were randomized to 16 weeks of ET (walking, arm and leg ergometry, n = 32) or attention control (CT) (n = 31). Peak Vo2, brachial artery FMD in response to cuff ischemia, carotid artery distensibility by high-resolution ultrasound, left ventricular function, and quality of life were measured at baseline and follow-up. RESULTS: ET increased peak Vo2 (ET: 15.8 ± 3.3 ml/kg/min vs. CT: 13.8 ± 3.1 ml/kg/min, p = 0.0001) and quality of life. However, brachial artery FMD (ET: 3.8 ± 3.0% vs. CT: 4.3 ± 3.5%, p = 0.88), and carotid arterial distensibility (ET: 0.97 ± 0.56 vs. CT: 1.07 ± 0.34 × 10(-3) mm·mm Hg(-2); p = 0.65) were unchanged. Resting left ventricular systolic and diastolic function were unchanged by ET. CONCLUSIONS: In elderly HFPEF patients, 16 weeks of ET improved peak Vo2 without altering endothelial function or arterial stiffness. This suggests that other mechanisms, such as enhanced skeletal muscle perfusion and/or oxygen utilization, may be responsible for the ET-mediated increase in peak Vo2 in older HFPEF patients. (Prospective Aerobic Reconditioning Intervention Study [PARIS]; NCT01113840). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/23665370/Effect_of_endurance_exercise_training_on_endothelial_function_and_arterial_stiffness_in_older_patients_with_heart_failure_and_preserved_ejection_fraction:_a_randomized_controlled_single_blind_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(13)01795-6 DB - PRIME DP - Unbound Medicine ER -