-
1.
Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial.
Balsam, P, Ozierański, K, Marchel, M, Gawałko, M, Niedziela, Ł, Tymińska, A, Sieradzki, B, Sieradzki, M, Fojt, A, Bakuła, E, et al
Cardiology journal. 2019;(6):661-668
Abstract
BACKGROUND Recent reports suggest that torasemide might be more beneficial than furosemide in patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and furosemide on clinical outcomes in HF patients. METHODS This study pilot consisted of data from the ongoing multicenter, randomized, unblinded endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association (NYHA) II-IV class with a stable dose of furosemide were randomized to treatment with equipotential dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease in fluid retention of at least 0.5 W after 3-months follow-up. RESULTS The study group included 40 patients (median age 66 years; 77.5% male). During follow-up 7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients). The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively (p = 0.03). CONCLUSIONS In HF patients treated with torasemide fluid overload and symptoms improved more than in the furosemide group. This positive effect occurred already within 3-month observation.
-
2.
The Association Between β-Blocker Use and Cardiorespiratory Fitness: The Maastricht Study.
Nielen, JTH, de Vries, F, van der Velde, JHPM, Savelberg, HHCM, Schaper, NC, Dagnelie, PC, Henry, RMA, Schram, M, Stehouwer, CDA, Boonen, A, et al
Journal of cardiovascular pharmacology and therapeutics. 2019;(1):37-45
-
-
Free full text
-
Abstract
PURPOSE β-Blockers (BBs) have been associated with a reduced cardiorespiratory fitness (CRF). This is possibly caused by inhibition of β2-receptors in the airways. However, there are limited data available on β-receptor selectivity and CRF. We therefore aimed to assess the association between BB use and CRF and to assess the association between β-receptor selectivity and CRF. METHODS Participants in the Maastricht Study were aged between 40 and 75 years. Exposure to BB use was determined by use of pharmacy records. General linear models were used to obtain adjusted means of 2 proxies for CRF: covered distance during the 6-minute walk test (6MWT) and estimated maximum power output adjusted for body mass ( Wmax kg-1) during the submaximal cycle ergometer test. Adjusted means were compared between current, past, and never BB users. Current users were subsequently stratified by β-receptor selectivity and dose. RESULTS Compared to never use, current use was associated with a lower CRF, based on the 6MWT (current use: 569.7 m; never use: 580.4 m [ P = .010]), but not based on the cycling test (current use: 2.14 W kg-1; never use: 2.13 W kg-1 [ P = .690]). There was no difference between current selective and current nonselective BB use. CONCLUSION β-Blockers use was associated with CRF based on the 6MWT but not the cycling test. There was no difference between current selective and nonselective BB users, possibly due to the small number of nonselective BB users, differential underlying diseases, other pharmacological properties, and limitations related to the proxies of the outcome.
-
3.
Oral taurine improves critical power and severe-intensity exercise tolerance.
Waldron, M, Patterson, SD, Jeffries, O
Amino acids. 2019;(10-12):1433-1441
Abstract
This study investigated the effects of acute oral taurine ingestion on: (1) the power-time relationship using the 3-min all-out test (3MAOT); (2) time to exhaustion (TTE) 5% > critical power (CP) and (3) the estimated time to complete (Tlim) a range of fixed target intensities. Twelve males completed a baseline 3MAOT test on a cycle ergometer. Following this, a double-blind, randomised cross-over design was followed, where participants were allocated to one of four conditions, separated by 72 h: TTE + taurine; TTE + placebo; 3MAOT + taurine; 3MAOT + placebo. Taurine was provided at 50 mg kg-1, whilst the placebo was 3 mg kg-1 maltodextrin. CP was higher (P < 0.05) in taurine (212 ± 36 W) than baseline (197 ± 40 W) and placebo (193 ± 35 W). Work end power was not affected by supplement (P > 0.05), yet TTE 5% > CP increased (P < 0.05) by 1.7 min after taurine (17.7 min) compared to placebo (16.0 min) and there were higher (P < 0.001) estimated Tlim across all work targets. Acute supplementation of 50 mg kg-1 of taurine improved CP and estimated performance at a range of severe work intensities. Oral taurine can be taken prior to exercise to enhance endurance performance.
-
4.
A combination of oral L-citrulline and L-arginine improved 10-min full-power cycling test performance in male collegiate soccer players: a randomized crossover trial.
Suzuki, I, Sakuraba, K, Horiike, T, Kishi, T, Yabe, J, Suzuki, T, Morita, M, Nishimura, A, Suzuki, Y
European journal of applied physiology. 2019;(5):1075-1084
-
-
Free full text
-
Abstract
PURPOSE Oral L-citrulline (Cit) increases plasma L-arginine (Arg) concentration and the production of nitric oxide (NO). NO dilates blood vessels and potentially improves sports performance. The combination of oral Arg and Cit (Arg + Cit) immediately and synergistically increases plasma Arg and nitrite/nitrate (NOx) concentrations more than either Cit or Arg alone. This prompted us to assess the effects of oral Arg + Cit on 10-min cycling performance in a double-blind, randomized, placebo-controlled crossover trial. METHODS Twenty-four male soccer players ingested either Cit + Arg or placebo (both 1.2 g/day each) for 6 days. On day 7, they ingested Cit + Arg 1 h before performing a 10-min full-power pedaling test on a bicycle ergometer. Plasma NOx and amino acid levels were measured before and after the test, as well as the participants' subjective perception of physical exertion. RESULTS Power output was significantly greater with Cit + Arg than in the placebo group (242 ± 24 vs. 231 ± 21 W; p < 0.05). Plasma concentrations of post-exercise NOx (p < 0.05), Cit (p < 0.01) and Arg (p < 0.01) were significantly higher in the Cit + Arg than in the placebo group, whereas exercise upregulated plasma NOx concentrations in both groups (p < 0.05). Cit + Arg also gave improved post-exercise subjective perception of "leg muscle soreness" and "ease of pedaling" (both p < 0.05). CONCLUSION Seven days of oral Citrulline (1.2 g/d) and Arginine (1.2 g/d) ingestion improved 10-min cycling performance and the perception of physical exertion in male collegiate soccer players.
-
5.
Iron deficiency in patients with heart failure with preserved ejection fraction and its association with reduced exercise capacity, muscle strength and quality of life.
Bekfani, T, Pellicori, P, Morris, D, Ebner, N, Valentova, M, Sandek, A, Doehner, W, Cleland, JG, Lainscak, M, Schulze, PC, et al
Clinical research in cardiology : official journal of the German Cardiac Society. 2019;(2):203-211
Abstract
BACKGROUND The prevalence of iron deficiency (ID) in outpatients with heart failure with preserved ejection fraction (HFpEF) and its relation to exercise capacity and quality of life (QoL) is unknown. METHODS 190 symptomatic outpatients with HFpEF (LVEF 58 ± 7%; age 71 ± 9 years; NYHA 2.4 ± 0.5; BMI 31 ± 6 kg/m2) were enrolled as part of SICA-HF in Germany, England and Slovenia. ID was defined as ferritin < 100 or 100-299 µg/L with transferrin saturation (TSAT) < 20%. Anemia was defined as Hb < 13 g/dL in men, < 12 g/dL in women. Low ferritin-ID was defined as ferritin < 100 µg/L. Patients were divided into 3 groups according to E/e' at echocardiography: E/e' ≤ 8; E/e' 9-14; E/e' ≥ 15. All patients underwent echocardiography, cardiopulmonary exercise test (CPX), 6-min walk test (6-MWT), and QoL assessment using the EQ5D questionnaire. RESULTS Overall, 111 patients (58.4%) showed ID with 89 having low ferritin-ID (46.84%). 78 (41.1%) patients had isolated ID without anemia and 54 patients showed anemia (28.4%). ID was more prevalent in patients with more severe diastolic dysfunction: E/e' ≤ 8: 44.8% vs. E/e': 9-14: 53.2% vs. E/e' ≥ 15: 86.5% (p = 0.0004). Patients with ID performed worse during the 6MWT (420 ± 137 vs. 344 ± 124 m; p = 0.008) and had worse exercise time in CPX (645 ± 168 vs. 538 ± 178 s, p = 0.03). Patients with low ferritin-ID had lower QoL compared to those without ID (p = 0.03). CONCLUSION ID is a frequent co-morbidity in HFpEF and is associated with reduced exercise capacity and QoL. Its prevalence increases with increasing severity of diastolic dysfunction.
-
6.
The relationship between physical activity and appetite in patients with heart failure: A prospective observational study.
Andreae, C, Årestedt, K, Evangelista, L, Strömberg, A
European journal of cardiovascular nursing. 2019;(5):410-417
-
-
Free full text
-
Abstract
INTRODUCTION Physical activity and appetite are important components for maintaining health. Yet, the association between physical activity and appetite in heart failure (HF) populations is not completely understood. The aim of the present study was to investigate the relationship between physical activity, functional capacity, and appetite in patients with HF. METHODS This was a prospective observational study. In total, 186 patients diagnosed with HF, New York Heart Association (NYHA) class II-IV (mean age 70.7, 30% female), were included. Physical activity was measured using a multi-sensor actigraph for seven days and with a self-reported numeric rating scale. Physical capacity was measured by the six-minute walk test. Appetite was measured using the Council on Nutrition Appetite Questionnaire. Data were collected at inclusion and after 18 months. A series of linear regression analyses, adjusted for age, NYHA class, and B-type natriuretic peptide were conducted. RESULTS At baseline, higher levels of physical activity and functional capacity were significantly associated with a higher level of appetite in the unadjusted models. In the adjusted models, number of steps ( p = 0.019) and the six-minute walk test ( p = 0.007) remained significant. At the 18-month follow-up, all physical activity variables and functional capacity were significantly associated with appetite in the unadjusted regression models. In the adjusted models, number of steps ( p = 0.001) and metabolic equivalent daily averages ( p = 0.040) remained significant. CONCLUSION A higher level of physical activity measured by number of steps/day was associated with better self-reported appetite, both at baseline and the 18-month follow-up. Further research is needed to establish causality and explore the intertwined relationship between activity and appetite in patients with HF.
-
7.
Dietary nitrate's effects on exercise performance in heart failure with reduced ejection fraction (HFrEF).
Mulkareddy, V, Racette, SB, Coggan, AR, Peterson, LR
Biochimica et biophysica acta. Molecular basis of disease. 2019;(4):735-740
Abstract
Heart failure with reduced ejection fraction (HFrEF) is a deadly and disabling disease. A key derangement contributing to impaired exercise performance in HFrEF is decreased nitric oxide (NO) bioavailability. Scientists recently discovered the inorganic nitrate pathway for increasing NO. This has advantages over organic nitrates and NO synthase production of NO. Small studies using beetroot juice as a source of inorganic nitrate demonstrate its power to improve exercise performance in HFrEF. A larger-scale trial is now underway to determine if inorganic nitrate may be a new arrow for physicians' quiver of HFrEF treatments.
-
8.
Dietary nitrate improved exercise capacity in COPD but not blood pressure or pulmonary function: a 2 week, double-blind randomised, placebo-controlled crossover trial.
Kerley, CP, James, PE, McGowan, A, Faul, J, Cormican, L
International journal of food sciences and nutrition. 2019;(2):222-231
Abstract
Dietary nitrate may improve exercise tolerance in some healthy and clinical populations. Existing data regarding dietary nitrate in COPD is inconsistent. We conducted a 14d double-blind, randomised, placebo-controlled, crossover trial of daily nitrate-rich beetroot juice (BRJ; 12.9 mmol) versus nitrate-depleted BRJ (PL; 0.5 mmol). At baseline and after each condition, we assessed functional capacity (incremental shuttle walk test; ISWT), ambulatory blood pressure, pulmonary function, quality of life as well as exhaled nitric oxide (eNO), and plasma nitrate/nitrite (NOx). Eight subjects with COPD completed the trial. BRJ supplementation was associated with significantly increased NOx (p < .05) and a 14.6% increase in ISWT distance (+56 m, p = .00004) as well as a trend towards increased eNO compared to PL. There was no other differences. Dietary nitrate appears to have ergogenic effect in subjects with mild-moderate COPD. This effect does not appear to be related to altering blood pressure or pulmonary function.
-
9.
Relationship between body composition and the level of aerobic and anaerobic capacity in highly trained male rowers.
Durkalec-Michalski, K, Nowaczyk, PM, Podgórski, T, Kusy, K, Osiński, W, Jeszka, J
The Journal of sports medicine and physical fitness. 2019;(9):1526-1535
Abstract
BACKGROUND Body composition may affect the potential for success in sports. For this reason, our study aimed to determine the impact of body composition on the level of aerobic and anaerobic capacity in competitive rowers. METHODS The study involved 48 males aged 20±2 years. Body composition was analysed using electrical bioimpedance. Maximum aerobic capacity (VO2max) and average anaerobic power (AP) were determined using an incremental cycling test until exhaustion and a standard Wingate Anaerobic Test (WAT), respectively. RESULTS The optimal ranges of body components with respect to the level of anaerobic and aerobic capacity at preparatory period for highly trained rowers aged 17-23 years, with body mass 67.5-104.7 kg, were 86-88% for fat free mass (FFM), 63-65% for total body water (TBW) and 11-13% for fat mass (FM). Regression analyses showed that BM and FFM significantly contributed to the prediction of VO2max and AP. The increase in FFM and BM by 1 kg resulted in the change of VO2max by +0.161 l.min-1 and -0.057 l.min-1, and AP by +5.51 W and +4.74 W, respectively. CONCLUSIONS Body composition is closely related to the level of aerobic and anaerobic capacity in rowers, and we suggest that its regulation can serve as an effective tool to improve physical performance. The regression models we developed seem to be promising for estimating the changes in physical capacity based on body composition modifications, however, their accuracy should be verified in an experimental study.
-
10.
High doses of sodium bicarbonate increase lactate levels and delay exhaustion in a cycling performance test.
Ferreira, LHB, Smolarek, AC, Chilibeck, PD, Barros, MP, McAnulty, SR, Schoenfeld, BJ, Zandona, BA, Souza-Junior, TP
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:94-99
Abstract
OBJECTIVES It is well established that ingestion of sodium bicarbonate (NaHCO3) causes metabolic alkalosis. However, there is no consensus in terms of optimal NaHCO3 doses leading to enhanced performance. This study aimed to determine the effects of different NaHCO3 doses on performance and lactate clearance in non-professional cyclists. METHODS Twenty-one cyclists performed the following three double-blind trials: 1) ingestion of 0.3 g · kg-1 body weight (BW) of placebo; 2) ingestion of 0.1 g · kg-1 BW NaHCO3 plus 0.2 g · kg-1 BW placebo (0.1 BC); and 3) ingestion of 0.3 g · kg-1 BW NaHCO3 (0.3 BC). Performance was evaluated after warm-up on the bike followed by a performance test until exhaustion. Lactate levels were monitored in blood samples before and immediately after performance tests. RESULTS Lactate levels in the blood were significantly higher after exercise in 0.3 BC and 0.1 BC (15.12 ± 0.92 versus 10.3 ± 1.22 and 13.24 ± 0.87 versus 10.3 ± 1.22 mmol/L; P < 0.05) compared with control. Significant improvements in performance were only identified in 0.3 BC group (76.42 ± 2.14; P = 0.01). CONCLUSIONS The present study found that 0.3 g · kg-1 BW NaHCO3 is effective in improving performance and improving blood lactate levels in cyclists compared with control and 0.1 g · kg-1 BW NaHCO3.