Exercise Training Attenuates Progressive Decline in Brachial Artery Reactivity in Heart Transplant Recipients

Randy W. Braith, Richard S. Schofield, James A. Hill, Darren P. Casey, Gary L. Pierce

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. Methods: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 ± 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. Results: The VO2 peak increased 26% in the Trained patients (15.4 ± 4.3 vs 19.4 ± 5.5 ml/kg/min; p ≤ 0.05) but did not change in the Controls (16.2 ± 5.2 vs 16.8 ± 2.8 ml/kg/min; p ≥ 0.05). Brachial artery flow-mediated dilation (10.1% ± 6.1% vs 9.6% ± 6.2%) and absolute brachial diameter (0.48 ± 0.22 vs 0.42 ± 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5% ± 2.8% vs 7.9% ± 5.1%) and the absolute change in brachial diameter (0.48 ± 0.16 vs 0.36 ± 0.24 mm) decreased significantly (p ≤ 0.05) in the Control patients. Resting norepinephrine decreased significantly (p ≤ 0.05) after training (0.32 ± 0.19 vs 0.22 ± 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 ± 0.17 vs 0.53 ± 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. Conclusions: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation.

Original languageEnglish (US)
Pages (from-to)52-59
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume27
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Brachial Artery
Dilatation
Exercise
Arm
Heart Transplantation
Norepinephrine
Oxidative Stress
Lipids
Sympathetic Nervous System
Transplant Recipients
Arteries
Transplantation
Hemodynamics
Prospective Studies
Transplants

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Exercise Training Attenuates Progressive Decline in Brachial Artery Reactivity in Heart Transplant Recipients. / Braith, Randy W.; Schofield, Richard S.; Hill, James A.; Casey, Darren P.; Pierce, Gary L.

In: Journal of Heart and Lung Transplantation, Vol. 27, No. 1, 01.2008, p. 52-59.

Research output: Contribution to journalArticle

Braith, Randy W. ; Schofield, Richard S. ; Hill, James A. ; Casey, Darren P. ; Pierce, Gary L. / Exercise Training Attenuates Progressive Decline in Brachial Artery Reactivity in Heart Transplant Recipients. In: Journal of Heart and Lung Transplantation. 2008 ; Vol. 27, No. 1. pp. 52-59.
@article{f1d0cc1ced39478793cd25464aa4a9d7,
title = "Exercise Training Attenuates Progressive Decline in Brachial Artery Reactivity in Heart Transplant Recipients",
abstract = "Background: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. Methods: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 ± 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. Results: The VO2 peak increased 26{\%} in the Trained patients (15.4 ± 4.3 vs 19.4 ± 5.5 ml/kg/min; p ≤ 0.05) but did not change in the Controls (16.2 ± 5.2 vs 16.8 ± 2.8 ml/kg/min; p ≥ 0.05). Brachial artery flow-mediated dilation (10.1{\%} ± 6.1{\%} vs 9.6{\%} ± 6.2{\%}) and absolute brachial diameter (0.48 ± 0.22 vs 0.42 ± 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5{\%} ± 2.8{\%} vs 7.9{\%} ± 5.1{\%}) and the absolute change in brachial diameter (0.48 ± 0.16 vs 0.36 ± 0.24 mm) decreased significantly (p ≤ 0.05) in the Control patients. Resting norepinephrine decreased significantly (p ≤ 0.05) after training (0.32 ± 0.19 vs 0.22 ± 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 ± 0.17 vs 0.53 ± 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. Conclusions: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation.",
author = "Braith, {Randy W.} and Schofield, {Richard S.} and Hill, {James A.} and Casey, {Darren P.} and Pierce, {Gary L.}",
year = "2008",
month = "1",
doi = "10.1016/j.healun.2007.09.032",
language = "English (US)",
volume = "27",
pages = "52--59",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - Exercise Training Attenuates Progressive Decline in Brachial Artery Reactivity in Heart Transplant Recipients

AU - Braith, Randy W.

AU - Schofield, Richard S.

AU - Hill, James A.

AU - Casey, Darren P.

AU - Pierce, Gary L.

PY - 2008/1

Y1 - 2008/1

N2 - Background: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. Methods: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 ± 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. Results: The VO2 peak increased 26% in the Trained patients (15.4 ± 4.3 vs 19.4 ± 5.5 ml/kg/min; p ≤ 0.05) but did not change in the Controls (16.2 ± 5.2 vs 16.8 ± 2.8 ml/kg/min; p ≥ 0.05). Brachial artery flow-mediated dilation (10.1% ± 6.1% vs 9.6% ± 6.2%) and absolute brachial diameter (0.48 ± 0.22 vs 0.42 ± 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5% ± 2.8% vs 7.9% ± 5.1%) and the absolute change in brachial diameter (0.48 ± 0.16 vs 0.36 ± 0.24 mm) decreased significantly (p ≤ 0.05) in the Control patients. Resting norepinephrine decreased significantly (p ≤ 0.05) after training (0.32 ± 0.19 vs 0.22 ± 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 ± 0.17 vs 0.53 ± 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. Conclusions: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation.

AB - Background: Heart transplantation normalizes central hemodynamics, but endothelial dysfunction persists after transplantation. Methods: To investigate the effects of aerobic exercise on arterial function, oxidative stress, lipid profile, and sympathetic nervous system activity, 20 heart transplant recipients (age, 54.3 ± 9.1 years; 17 men, 3 women) were randomly assigned to 12 weeks of supervised treadmill exercise (Trained; n = 10) or standard medical care (Control; n = 10). Supervised exercise was initiated at 8 weeks after transplant. Brachial artery reactivity was assessed using flow-mediated dilation. Results: The VO2 peak increased 26% in the Trained patients (15.4 ± 4.3 vs 19.4 ± 5.5 ml/kg/min; p ≤ 0.05) but did not change in the Controls (16.2 ± 5.2 vs 16.8 ± 2.8 ml/kg/min; p ≥ 0.05). Brachial artery flow-mediated dilation (10.1% ± 6.1% vs 9.6% ± 6.2%) and absolute brachial diameter (0.48 ± 0.22 vs 0.42 ± 0.24 mm) did not change in Trained patients, but brachial flow-mediated dilation (10.5% ± 2.8% vs 7.9% ± 5.1%) and the absolute change in brachial diameter (0.48 ± 0.16 vs 0.36 ± 0.24 mm) decreased significantly (p ≤ 0.05) in the Control patients. Resting norepinephrine decreased significantly (p ≤ 0.05) after training (0.32 ± 0.19 vs 0.22 ± 0.22 ng/ml), but there was a nonsignificant trend toward increased norepinephrine in the Controls (0.26 ± 0.17 vs 0.53 ± 0.41 ng/ml; p = 0.07). The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention. Conclusions: To our knowledge, this is the first prospective, randomized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients. Brachial artery flow-mediated dilation increased early in the post-operative period. Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation. Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation.

UR - http://www.scopus.com/inward/record.url?scp=37549031324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37549031324&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2007.09.032

DO - 10.1016/j.healun.2007.09.032

M3 - Article

VL - 27

SP - 52

EP - 59

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 1

ER -