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Park LK, Coggan AR, Peterson LR. Skeletal Muscle Contractile Function in Heart Failure With Reduced Ejection Fraction-A Focus on Nitric Oxide. Front Physiol 2022; 13:872719. [PMID: 35721565 PMCID: PMC9198547 DOI: 10.3389/fphys.2022.872719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Despite advances over the past few decades, heart failure with reduced ejection fraction (HFrEF) remains not only a mortal but a disabling disease. Indeed, the New York Heart Association classification of HFrEF severity is based on how much exercise a patient can perform. Moreover, exercise capacity-both aerobic exercise performance and muscle power-are intimately linked with survival in patients with HFrEF. This review will highlight the pathologic changes in skeletal muscle in HFrEF that are related to impaired exercise performance. Next, it will discuss the key role that impaired nitric oxide (NO) bioavailability plays in HFrEF skeletal muscle pathology. Lastly, it will discuss intriguing new data suggesting that the inorganic nitrate 'enterosalivary pathway' may be leveraged to increase NO bioavailability via ingestion of inorganic nitrate. This ingestion of inorganic nitrate has several advantages over organic nitrate (e.g., nitroglycerin) and the endogenous nitric oxide synthase pathway. Moreover, inorganic nitrate has been shown to improve exercise performance: both muscle power and aerobic capacity, in some recent small but well-controlled, cross-over studies in patients with HFrEF. Given the critical importance of better exercise performance for the amelioration of disability as well as its links with improved outcomes in patients with HFrEF, further studies of inorganic nitrate as a potential novel treatment is critical.
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Affiliation(s)
- Lauren K. Park
- Department of Medicine, Cardiology Division, Washington University School of Medicine, Saint Louis, MO, United States
| | - Andrew R. Coggan
- Department of Kinesiology, Indiana University Purdue University, Indianapolis, IN, United States
| | - Linda R. Peterson
- Department of Medicine, Cardiology Division, Washington University School of Medicine, Saint Louis, MO, United States
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Dalton RL, Sowinski RJ, Grubic TJ, Collins PB, Coletta AM, Reyes AG, Sanchez B, Koozehchian M, Jung YP, Rasmussen C, Greenwood M, Murano PS, Earnest CP, Kreider RB. Hematological and Hemodynamic Responses to Acute and Short-Term Creatine Nitrate Supplementation. Nutrients 2017; 9:nu9121359. [PMID: 29244743 PMCID: PMC5748809 DOI: 10.3390/nu9121359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 11/16/2022] Open
Abstract
In a double-blind, crossover, randomized and placebo-controlled trial; 28 men and women ingested a placebo (PLA), 3 g of creatine nitrate (CNL), and 6 g of creatine nitrate (CNH) for 6 days. Participants repeated the experiment with the alternate supplements after a 7-day washout. Hemodynamic responses to a postural challenge, fasting blood samples, and bench press, leg press, and cycling time trial performance and recovery were assessed. Data were analyzed by univariate, multivariate, and repeated measures general linear models (GLM). No significant differences were found among treatments for hemodynamic responses, clinical blood markers or self-reported side effects. After 5 days of supplementation, one repetition maximum (1RM) bench press improved significantly for CNH (mean change, 95% CI; 6.1 [3.5, 8.7] kg) but not PLA (0.7 [-1.6, 3.0] kg or CNL (2.0 [-0.9, 4.9] kg, CNH, p = 0.01). CNH participants also tended to experience an attenuated loss in 1RM strength during the recovery performance tests following supplementation on day 5 (PLA: -9.3 [-13.5, -5.0], CNL: -9.3 [-13.5, -5.1], CNH: -3.9 [-6.6, -1.2] kg, p = 0.07). After 5 days, pre-supplementation 1RM leg press values increased significantly, only with CNH (24.7 [8.8, 40.6] kg, but not PLA (13.9 [-15.7, 43.5] or CNL (14.6 [-0.5, 29.7]). Further, post-supplementation 1RM leg press recovery did not decrease significantly for CNH (-13.3 [-31.9, 5.3], but did for PLA (-30.5 [-53.4, -7.7] and CNL (-29.0 [-49.5, -8.4]). CNL treatment promoted an increase in bench press repetitions at 70% of 1RM during recovery on day 5 (PLA: 0.4 [-0.8, 1.6], CNL: 0.9 [0.35, 1.5], CNH: 0.5 [-0.2, 0.3], p = 0.56), greater leg press endurance prior to supplementation on day 5 (PLA: -0.2 [-1.6, 1.2], CNL: 0.9 [0.2, 1.6], CNH: 0.2 [-0.5, 0.9], p = 0.25) and greater leg press endurance during recovery on day 5 (PLA: -0.03 [-1.2, 1.1], CNL: 1.1 [0.3, 1.9], CNH: 0.4 [-0.4, 1.2], p = 0.23). Cycling time trial performance (4 km) was not affected. Results indicate that creatine nitrate supplementation, up to a 6 g dose, for 6 days, appears to be safe and provide some ergogenic benefit.
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Affiliation(s)
- Ryan L Dalton
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Ryan J Sowinski
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Tyler J Grubic
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Patrick B Collins
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Adriana M Coletta
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Aimee G Reyes
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Brittany Sanchez
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Majid Koozehchian
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Yanghoon P Jung
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Christopher Rasmussen
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Mike Greenwood
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
| | - Peter S Murano
- Institute for Obesity and Program Evaluation, Texas A & M University, College Station, TX 77843, USA.
| | - Conrad P Earnest
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
- Clinical Science Division, Nutrabolt, 3891 S. Traditions Drive, Bryan, TX 77807, USA.
| | - Richard B Kreider
- Exercise and Sport Nutrition Lab, Human Clinical Research Facility, Texas A & M University, College Station, TX 77843-4253, USA.
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Bast A, Hanekamp JC. "You Can't Always Get What You Want" - Linearity as the Golden Ratio of Toxicology. Dose Response 2014; 12:664-72. [PMID: 25552963 PMCID: PMC4267455 DOI: 10.2203/dose-response.13-032.hanekamp] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Referring to the Golden Ratio (i.e. expressed in the Fibonacci sequence) in nature and art, we conclude that toxicology knows its own Golden Ration, namely linearity. The latter seems imposed on pharmaco-toxicological processes that in fact show far more complexity than simple linearity could hope to elucidate. Understanding physiological and pharmaco-toxicological processes as primarily linear is challenged in this contribution based on very straightforward principles and examples.
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Affiliation(s)
- Aalt Bast
- Professor of Human Toxicology, Department of Toxicology, Maastricht University, The Netherlands
| | - Jaap C Hanekamp
- Associate Professor at the University College Roosevelt, Middelburg, The Netherlands; Adjunct at the University of Massachusetts Amherst, Environmental Health Sciences
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