Sodium nitrite improves exercise hemodynamics and ventricular performance in heart failure with preserved ejection fraction

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059687" target="_blank" >RIV/00023001:_____/15:00059687 - isvavai.cz</a>

Výsledek na webu

<a href="http://www.sciencedirect.com/science/article/pii/S0735109715048573" target="_blank" >http://www.sciencedirect.com/science/article/pii/S0735109715048573</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacc.2015.07.067" target="_blank" >10.1016/j.jacc.2015.07.067</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Sodium nitrite improves exercise hemodynamics and ventricular performance in heart failure with preserved ejection fraction

Popis výsledku v původním jazyce

BACKGROUND There is no effective medical treatment for heart failure with preserved ejection fraction (HFpEF). Increases in pulmonary capillary wedge pressure (PCWP) develop in patients with HFpEF during exercise coupled with impaired nitric oxide (NO) signaling. Nitrite can be reduced to bioactive NO in vivo, particularly under conditions of tissue hypoxia, as with exercise. OBJECTIVES This study sought to determine whether acute nitrite administration improves exercise hemodynamics and cardiac reserve in HFpEF. METHODS In a double-blind, randomized, placebo-controlled, parallel-group trial, subjects with HFpEF (N = 28) underwent invasive cardiac catheterization with simultaneous expired gas analysis at rest and during exercise, before and 15 min after treatment with either sodium nitrite or matching placebo. RESULTS Before the study drug infusion, HFpEF subjects displayed an increase in PCWP with exercise from 16 +/- 5 mm Hg to 30 +/- 7 mm Hg (p < 0.0001). After study drug infusion, the primary endpoint of exercise PCWP was substantially improved by nitrite compared with placebo (adjusted mean: 19 +/- 5 mm Hg vs. 28 +/- 6 mm Hg; p = 0.0003). Nitrite-enhanced cardiac output reserve improved with exercise (+0.5 +0.7 l/min vs. -0.4 +/- 0.7 l/min; p = 0.002) and normalized the increase in cardiac output relative to oxygen consumption. Nitrite improved pulmonary artery pressure-flow relationships in HFpEF and increased left ventricular stroke work with exercise versus placebo, indicating an improvement in ventricular performance with stress. CONCLUSIONS Acute sodium nitrite infusion favorably attenuates hemodynamic derangements of cardiac failure that develop during exercise in individuals with HFpEF. Prospective trials testing long-term nitrite therapy in this population are warranted. (Acute Effects of Inorganic Nitrite on Cardiovascular Hemodynamics in Heart Failure With Preserved Ejection Fraction; NCT01932606) (C) 2015 by the ACCF.

Název v anglickém jazyce

Sodium nitrite improves exercise hemodynamics and ventricular performance in heart failure with preserved ejection fraction

Popis výsledku anglicky

BACKGROUND There is no effective medical treatment for heart failure with preserved ejection fraction (HFpEF). Increases in pulmonary capillary wedge pressure (PCWP) develop in patients with HFpEF during exercise coupled with impaired nitric oxide (NO) signaling. Nitrite can be reduced to bioactive NO in vivo, particularly under conditions of tissue hypoxia, as with exercise. OBJECTIVES This study sought to determine whether acute nitrite administration improves exercise hemodynamics and cardiac reserve in HFpEF. METHODS In a double-blind, randomized, placebo-controlled, parallel-group trial, subjects with HFpEF (N = 28) underwent invasive cardiac catheterization with simultaneous expired gas analysis at rest and during exercise, before and 15 min after treatment with either sodium nitrite or matching placebo. RESULTS Before the study drug infusion, HFpEF subjects displayed an increase in PCWP with exercise from 16 +/- 5 mm Hg to 30 +/- 7 mm Hg (p < 0.0001). After study drug infusion, the primary endpoint of exercise PCWP was substantially improved by nitrite compared with placebo (adjusted mean: 19 +/- 5 mm Hg vs. 28 +/- 6 mm Hg; p = 0.0003). Nitrite-enhanced cardiac output reserve improved with exercise (+0.5 +0.7 l/min vs. -0.4 +/- 0.7 l/min; p = 0.002) and normalized the increase in cardiac output relative to oxygen consumption. Nitrite improved pulmonary artery pressure-flow relationships in HFpEF and increased left ventricular stroke work with exercise versus placebo, indicating an improvement in ventricular performance with stress. CONCLUSIONS Acute sodium nitrite infusion favorably attenuates hemodynamic derangements of cardiac failure that develop during exercise in individuals with HFpEF. Prospective trials testing long-term nitrite therapy in this population are warranted. (Acute Effects of Inorganic Nitrite on Cardiovascular Hemodynamics in Heart Failure With Preserved Ejection Fraction; NCT01932606) (C) 2015 by the ACCF.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2015

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of the American College of Cardiology

ISSN

0735-1097

e-ISSN

—

Svazek periodika

66

Číslo periodika v rámci svazku

15

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

1672-1682

Kód UT WoS článku

000363329200005

EID výsledku v databázi Scopus

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