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Departments of 1 Human Movement and Exercise Science and 2 Medicine, The University of Western Australia, Nedlands 6907; and 3 Department of Cardiology and 4 Cardiac Transplant Unit, Royal Perth Hospital and West Australian Heart Research Institute, Perth 6000, Western Australia
Exercise training of a
muscle group improves local vascular function in subjects with chronic
heart failure (CHF). We studied forearm resistance vessel function in
12 patients with CHF in response to an 8-wk exercise program, which
specifically excluded forearm exercise, using a crossover design.
Forearm blood flow (FBF) was measured using strain-gauge
plethysmography. Responses to three dose levels of intra-arterial
acetylcholine were significantly augmented after exercise training when
analyzed in terms of absolute flows (7.0 ± 1.8 to 10.9 ± 2.1 ml · 100 ml
1 · min1 for
the highest dose, P < 0.05 by ANOVA), forearm vascular
resistance (21.5 ± 5.0 to 15.3 ± 3.9 ml · 100 ml
forearm1 · min1, P < 0.01), or FBF ratios (P < 0.01, ANOVA). FBF ratio
responses to sodium nitroprusside were also significantly increased
after training (P < 0.05, ANOVA). Reactive hyperemic
flow significantly increased in both upper limbs after training
(27.9 ± 2.7 to 33.5 ± 3.1 ml · 100 ml1 · min1, infused limb;
P < 0.05 by paired t-test). Exercise
training improves endothelium-dependent and -independent vascular
function and peak vasodilator capacity in patients with CHF. These
effects on the vasculature are generalized, as they were evident in a vascular bed not directly involved in the exercise stimulus.
endothelium; nitric oxide; acetylcholine; blood flow; chronic heart failure
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