Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure

被引:217
作者
Rector, TS
Bank, AJ
Mullen, KA
Tschumperlin, LK
Sih, R
Pillai, K
Kubo, SH
机构
[1] Cardiovascular Division, Department of Medicine, Univ. of Minnesota Medical School, Minneapolis, MN
[2] Box 508 UMHC, Univ. of Minnesota Medical School, Minneapolis, MN 55455
关键词
heart failure; endothelium; L-arginine;
D O I
10.1161/01.CIR.93.12.2135
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Patients with heart failure have reduced peripheral blood flow at rest, during exercise, and in response to endothelium-dependent vasodilators. Nitric oxide formed from L-arginine metabolism in endothelial cells contributes to regu lation of blood flow under these conditions. A randomized, double-blind crossover study design was used to determine whether supplemental oral L-arginine can augment peripheral blood flow and improve functional status in patients with moderate to severe heart failure. Methods and Results Fifteen subjects were given 6 weeks of oral L-arginine hydrochloride (5.6 to 12.6 g/d) and 6 weeks of matched placebo capsules in random sequence. Compared with placebo, supplemental oral L-arginine significantly increased forearm blood flow during forearm exercise, on average from 5.1 +/- 2.8 to 6.6 +/- 3.4 mL . min(-1). dL(-1) (P<.05). Furthermore, functional status was significantly better on L-arginine compared with placebo, as indicated by increased distances during a 6-minute walk test (390 +/- 91 versus 422 +/- 86 m, P<.05) and lower scores on the Living With Heart Failure questionnaire (55 +/- 28 versus 42 +/- 26, P<.05). Oral L-arginine also improved arterial compliance from 1.99 +/- 0.38 to 2.36 +/- 0.30 mL/mm Hg (P<.001) and reduced circulating levels of endothelin from 1.9 +/- 1.1 to 1.5 +/- 1.1 pmol/L (P<.05). Conclusions Supplemental oral L-arginine had beneficial effects in patients with heart failure. Further studies are needed to confirm the therapeutic potential of supplemental oral L-arginine and to identify mechanisms of action in patients with heart failure.
引用
收藏
页码:2135 / 2141
页数:7
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