title: Effects of exercise training on forearm and calf vasodilation and proinflammatory markers in recent heart transplant recipients: a pilot study.
abstract: BACKGROUND
  Aerobic exercise training improves vasodilatory capacity of peripheral resistance vasculature and modifies plasma proinflammatory markers in chronic heart failure patients. It is, however, currently unknown whether aerobic exercise has a similar effect in heart transplant recipients (HTR).
  
  
  METHODS
  Eight weeks after transplantation, 14 HTR were randomly assigned to 12 weeks of supervised aerobic exercise training (TRAINED; n=8) or attention-time control (CONTROL; n=6) in addition to posttransplantation medical care. Peak forearm blood flow and calf blood flow (CBF) during reactive hyperemia after 5 min of limb ischemia was used as a measure of endothelium-dependent vasodilation of limb resistance arteries. Plasma C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble intercellular adhesion molecule-1 (sICAM-1), and exercise capacity were measured at baseline and again after 12 weeks in both groups.
  
  
  RESULTS
  Peak CBF increased 22% in the TRAINED (25.9+/-5.8-31.6+/-7.9 ml/min/100 ml, P<0.05), but there was no change in peak CBF after 12 weeks in CONTROL. Plasma C-reactive protein, IL-6, TNF-alpha, sICAM-1 did not change in TRAINED, but there was a significant increase in TNF-alpha (1.66+/-1.02 vs. 3.07+/-1.10 pg/ml, P<0.05), and sICAM-1 (205.9+/-59.1 vs. 245.0+/-47.9 ng/ml, P<0.01) in CONTROL after 12 weeks. Furthermore, exercise test duration improved 51.7% (P<0.01) and there was a trend toward an increase in peak VO2 (P=0.05) in TRAINED after 12 weeks but neither changed in CONTROL.
  
  
  CONCLUSIONS
  A program of supervised aerobic exercise improves endothelium-dependent vasodilation of the calf, but not forearm resistance arteries, and may attenuate a progressive increase in selected proinflammatory markers in HTR.
authors.affiliation: Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA. gpierce@colorado.edu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Pierce
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schofield
authors.forename: Darren P
authors.initials: DP
authors.lastname: Casey
authors.forename: Scott A
authors.initials: SA
authors.lastname: Hamlin
authors.forename: James A
authors.initials: JA
authors.lastname: Hill
authors.forename: Randy W
authors.initials: RW
authors.lastname: Braith
mesh_terms: D000704:Analysis of Variance; D001783:Blood Flow Velocity; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010865:Pilot Projects; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014655:Vascular Resistance; D014664:Vasodilation / Q000502:physiology*
chemical_list: D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein