title: Exercise training in patients with chronic heart failure improves endothelial function predominantly in the trained extremities.
abstract: The present study investigates whether lower-limb dominant exercise training in patients with chronic heart failure (CHF) improves endothelial function primarily in the trained lower extremities or equally in the upper and lower extremities. Twenty-eight patients with CHF were randomized to the exercise or control group. The exercise group underwent cycle ergometer training for 3 months while controls continued an inactive sedentary lifestyle. Exercise capacity (6-min walk test) and flow-mediated vasodilation in the brachial and posterior tibial arteries were evaluated. After 3 months, walking performance increased only in the exercise group (488+/-16 to 501+/-14 m [control]; 497+/-23 to 567+/-39 m [exercise, p<0.05]). The flow-mediated vasodilation in the brachial arteries did not change in either group (4.2+/-0.5 to 4.5+/-0.4% [control]; 4.3+/-0.5 to 4.6+/-0.4% [exercise]), but that in the posterior tibial arteries increased only in the exercise group (4.1+/-0.5 to 4.1+/-0.3% [control]; 3.6+/-0.3 to 6.4+/-0.6% [exercise, p<0.01]). Cycle ergometer training improved flow-mediated vasodilation in the trained lower limbs, but not in the untrained upper limbs. Exercise training appears to correct endothelial dysfunction predominantly by a local effect in the trained extremities.
authors.affiliation: Cardiovascular Division, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tsuruya
authors.forename: Takamasa
authors.initials: T
authors.lastname: Iwasawa
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ueba
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Mikihisa
authors.initials: M
authors.lastname: Fujii
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
mesh_terms: D001132:Arm / Q000098:blood supply*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography; D014664:Vasodilation
chemical_list: D019332:Endothelin-1