Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Exercise Training in Patients With Chronic Heart Failure Improves Endothelial Function Predominantly in the Trained Extremities
Nobuhiko KobayashiYoshio TsuruyaTakamasa IwasawaNahoko IkedaShigemasa HashimotoTakanori YasuHiroto UebaNorifumi KuboMikihisa FujiiMasanobu KawakamiMuneyasu Saito
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2003 Volume 67 Issue 6 Pages 505-510


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. (Circ J 2003; 67: 505 - 510)

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