Dietary Nitrate Increases VO2peak and Performance but Does Not Alter Ventilation or Efficiency in Patients With Heart Failure With Reduced Ejection Fraction

Andrew R. Coggan, Seth R. Broadstreet, Kiran Mahmood, Deana Mikhalkova, Michael Madigan, Indra Bole, Soo Park, Joshua L. Leibowitz, Ana Kadkhodayan, Deepak P. Thomas, Dakkota Thies, Linda R. Peterson

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20 Scopus citations

Abstract

Background: Patients with heart failure with reduced ejection fraction (HFrEF) exhibit lower efficiency, dyspnea, and diminished peak oxygen uptake (VO2peak) during exercise. Dietary nitrate (NO3 ), a source of nitric oxide (NO), has improved these measures in some studies of other populations. We determined the effects of acute NO3 ingestion on exercise responses in 8 patients with HFrEF using a randomized, double-blind, placebo-controlled, crossover design. Methods and Results: Plasma NO3 , nitrite (NO2 ), and breath NO were measured at multiple time points and respiratory gas exchange was determined during exercise after ingestion of beetroot juice containing or devoid of 11.2 mmol of NO3 . NO3 intake increased (P <.05–0.001) plasma NO3 and NO2 and breath NO by 1469 ± 245%, 105 ± 34%, and 60 ± 18%, respectively. Efficiency and ventilation during exercise were unchanged. However, NO3 ingestion increased (P <.05) VO2peak by 8 ± 2% (ie, from 21.4 ± 2.1 to 23.0 ± 2.3 mL.min−1.kg−1). Time to fatigue improved (P <.05) by 7 ± 3 % (ie, from 582 ± 84 to 612 ± 81 seconds). Conclusions: Acute dietary NO3 intake increases VO2peak and performance in patients with HFrEF. These data, in conjunction with our recent data demonstrating that dietary NO3 also improves muscle contractile function, suggest that dietary NO3 supplementation may be a valuable means of enhancing exercise capacity in this population.

Original languageEnglish
Pages (from-to)65-73
Number of pages9
JournalJournal of cardiac failure
Volume24
Issue number2
DOIs
StatePublished - Feb 2018

Keywords

  • Nitric oxide
  • VOpeak
  • exercise
  • heart failure

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    Coggan, A. R., Broadstreet, S. R., Mahmood, K., Mikhalkova, D., Madigan, M., Bole, I., Park, S., Leibowitz, J. L., Kadkhodayan, A., Thomas, D. P., Thies, D., & Peterson, L. R. (2018). Dietary Nitrate Increases VO2peak and Performance but Does Not Alter Ventilation or Efficiency in Patients With Heart Failure With Reduced Ejection Fraction. Journal of cardiac failure, 24(2), 65-73. https://doi.org/10.1016/j.cardfail.2017.09.004