Relation between change in exercise capacity and change in blood amino acids in patients with chronic heart failure.
Nobuo Morotomi, Masakazu Saitoh, Noriko Ishii and 4 others
PMID 28356624WHAT IT FOUND
After three months of cardiac rehab in chronic heart failure, blood amino acid levels did not change in a way the study could detect among 12 patients.
A change in citrulline was linked with improvement in exercise capacity, but there was no control group.
Key findings
01In the 12 patients analysed, no plasma amino acid level changed significantly after cardiac rehabilitation.
02In the 12 patients who had exercise testing, a change in citrulline was positively correlated with changes in anaerobic threshold, work rate at anaerobic threshold, and oxygen uptake per work rate.
03In the 12 patients who had exercise testing, anaerobic threshold and peak oxygen uptake improved significantly after cardiac rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 20 patients were enrolled, and the exercise testing analysis was done in 12 patients. There was no control group, so the study cannot show that cardiac rehabilitation caused the changes. Patients received several components at the same time: aerobic exercise, dietitian-led nutritional guidance, and nurse-led self-care guidance, so the contribution of any single component cannot be separated. Only 60% of patients had cardiopulmonary exercise testing, and some had low muscle strength, so the results may not apply to patients who could not complete exercise testing. The correlations were based on change scores in 12 patients, and the small sample may make the associations unstable. Aspartic acid was not measured, so the amino acid profile was incomplete.
Declared interests
No funding or conflict-of-interest statement is given. Plasma samples were sent to the Ajinomoto Institute for Innovation for amino acid analysis, with individual identification masked.
The easy way to misread this
Do not conclude that raising citrulline improves exercise capacity or that cardiac rehabilitation caused the improvement. The study had no control group, only 12 patients had exercise testing, and patients also received nutritional guidance and nurse-led self-care guidance, so the effect of any single component cannot be separated.