title: Regular physical exercise improves endothelial function in heart transplant recipients.
abstract: BACKGROUND
  Impaired endothelial function is detectable in heart transplant (HTX) recipients and regarded as risk factor for coronary artery disease. We have studied whether endothelial function can be improved in HTX patients participating in a regular physical training program as demonstrated in patients with chronic heart failure, hypertension and coronary artery disease.
  
  
  METHODS
  Male HTX patients and healthy, age-matched controls were studied. Seven HTX patients (age: 60 +/- 6 yr; 6 +/- 2 yr of HTX) participated in an outpatient training program, six HTX patients (age: 63 +/- 8 yr; 7 +/- 1 yr of HTX) maintained a sedentary lifestyle without regular physical exercise since transplantation. A healthy control group comprised six subjects (age: 62 +/- 6 yr). Vascular function was assessed by flow-mediated dilation of the brachial artery (FMD). Systemic haemodynamic responses to intravenous infusion of the endothelium independent vasodilator sodium nitroprusside (SNP) and to NG-monomethyl-L-arginine (L-NMMA), an inhibitor of constitutive nitric oxide synthase, were also measured.
  
  
  RESULTS
  Resting heart rate was significantly lower (p < 0.05) in healthy controls (66 +/- 13) than in the HTX training group (83 +/- 11) and in non-training HTX patients (91 +/- 9), baseline blood pressure also tended to be lower in healthy subjects and in the training HTX patients. FMD was significantly higher (p < 0.05) in the control group (8.4 +/- 2.2%) and in the training group (7.1 +/- 2.4%), compared with non-training HTX patients (1.4 +/- 0.8%). The response of systolic blood pressure (p = 0.08) and heart rate (p < 0.05) to L-NMMA was reduced in sedentary HTX patients compared with healthy controls and heart rate response to SNP was also impaired in sedentary HTX patients.
  
  
  CONCLUSIONS
  Regular aerobic physical training restores vascular function in HTX patients, who are at considerable risk for developing vascular complications. This effect is demonstrable in conduit and systemic resistance arteries.
authors.affiliation: Department of Clinical Pharmacology, University of Vienna, Austria.
authors.forename: Alice
authors.initials: A
authors.lastname: Schmidt
authors.forename: Johannes
authors.initials: J
authors.lastname: Pleiner
authors.forename: Michaela
authors.initials: M
authors.lastname: Bayerle-Eder
authors.forename: Günther F
authors.initials: GF
authors.lastname: Wiesinger
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rödler
authors.forename: Michael
authors.initials: M
authors.lastname: Quittan
authors.forename: Gert
authors.initials: G
authors.lastname: Mayer
authors.forename: Michael
authors.initials: M
authors.lastname: Wolzt
mesh_terms: D001794:Blood Pressure; D001916:Brachial Artery; D004730:Endothelium, Vascular / Q000503:physiopathology*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005081:Exercise Therapy; D006339:Heart Rate; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D009599:Nitroprusside / Q000494:pharmacology; D012307:Risk Factors; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology; D019323:omega-N-Methylarginine / Q000494:pharmacology
chemical_list: D004791:Enzyme Inhibitors; D014665:Vasodilator Agents; D009599:Nitroprusside; D019323:omega-N-Methylarginine; D019001:Nitric Oxide Synthase