Endogenous nitric oxide in patients with chronic heart failure (CHF): relation to functional impairment and nitrate-containing therapies.
We assessed the levels of exhaled nitric oxide (eNO) in patients with chronic heart failure (CHF) according to the functional impairment and the use of nitrate-containing agents. Forty patients (age 55+/-9 years) were classified according to the NYHA classes I-II (n=18, group 1) and classes III-IV (n=22, group 2), and to the use of nitrate-containing drugs (Nitrate+, Nitrate-). Twenty-two healthy age-related subjects served as controls (group 3). Respiratory function, symptom-limited incremental cycloergometry and resting eNO concentration at peak (FENOp) or plateau (FENOpl) of the single-breath exhalation curve were assessed in all subjects. FENOpl was significantly lower in patients than in controls (7.8+/-2.7 and 10.6+/-2.8 ppb, respectively, P<0.005) and lower in most severe CHF patients (7.1+/-2.6 and 8.8+/-2.7 ppb in group 2 and group 1, respectively, P<0.05). A significant correlation between peak V'O(2), Watts and FENOpl (r=0.42, P<0.013 and r=0.46, P=0.008, respectively) was found. Independent of NYHA class, Nitrate+ showed higher FENOp levels than Nitrate- patients (36.9+/-15.7 vs. 28. 1+/-15.1 ppb, P<0.05). Resting eNO was lower in the most compromised CHF patients and was significantly related to exercise capacity. Nitrate-containing agents might influence the levels of eNO in these patients.
Clini
E
E
Fondazione Salvatore Maugeri IRCCS, Lung Function Unit and Division of Pneumology, Medical Center of Gussago (BS), 25064, Gussago, Italy. fsm.g2@numerica.it
Volterrani
M
M
Pagani
M
M
Bianchi
L
L
Porta
R
R
Gile'
L S
LS
Giordano
A
A
Ambrosino
N
N
D001784:Blood Gas Analysis; D001944:Breath Tests; D006328:Cardiac Catheterization; D002908:Chronic Disease; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000032:analysis / Q000096:biosynthesis*; D012129:Respiratory Function Tests
D009566:Nitrates; D009569:Nitric Oxide