title: Training-induced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: an extra benefit of water-based exercises?
abstract: BACKGROUND
  Rehabilitation programs involving immersed exercises are more and more frequently used, with severe cardiac patients as well.
  
  
  METHODS
  This study investigated whether a rehabilitation program including water-based exercises has additional effects on the cardiovascular system compared with a traditional land-based training in heart disease patients.
  
  
  METHODS
  Twenty-four male stable chronic heart failure patients and 24 male coronary artery disease patients with preserved left ventricular function participated in the study. Patients took part in the rehabilitation program performing cycle endurance exercises on land. They also performed gymnastic exercises either on land (first half of the participants) or in water (second half). Resting plasma concentration of nitric oxide metabolites (nitrate and nitrite) and catecholamine were evaluated, and a symptom-limited exercise test on a cycle ergometer was performed before and after the rehabilitation program.
  
  
  RESULTS
  In the groups performing water-based exercises, the plasma concentration of nitrates was significantly increased (P = 0.035 for chronic heart failure and P = 0.042 for coronary artery disease), whereas it did not significantly change in the groups performing gymnastic exercise on land. No changes in plasma catecholamine concentration occurred.
  
  
  CONCLUSIONS
  In every group, the cardiorespiratory capacity of patients was significantly increased after rehabilitation. The water-based exercises seemed to effectively increase the basal level of plasma nitrates. Such changes may be related to an enhancement of endothelial function and may be of importance for the health of the patients.
authors.affiliation: Université de Franche Comté, IFR 133 EA3920, Physiologie, Faculté de Médecine, Besançon, France. mourotlaurent@hotmail.com
authors.forename: Mourot
authors.initials: M
authors.lastname: Laurent
authors.forename: Teffaha
authors.initials: T
authors.lastname: Daline
authors.forename: Bouhaddi
authors.initials: B
authors.lastname: Malika
authors.forename: Ounissi
authors.initials: O
authors.lastname: Fawzi
authors.forename: Vernochet
authors.initials: V
authors.lastname: Philippe
authors.forename: Dugue
authors.initials: D
authors.lastname: Benoit
authors.forename: Monpère
authors.initials: M
authors.lastname: Catherine
authors.forename: Regnard
authors.initials: R
authors.lastname: Jacques
mesh_terms: D001642:Bicycling; D015415:Biomarkers / Q000097:blood; D002395:Catecholamines / Q000097:blood; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D006173:Gymnastics; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007101:Immersion; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009566:Nitrates / Q000097:blood; D009569:Nitric Oxide / Q000097:blood*; D009573:Nitrites / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013551:Swimming Pools; D016896:Treatment Outcome; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D002395:Catecholamines; D009566:Nitrates; D009573:Nitrites; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009569:Nitric Oxide