PMID- 29199900
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2045-8932 (Print)
IS  - 2045-8940 (Electronic)
IS  - 2045-8932 (Linking)
VI  - 8
IP  - 1
DP  - 2018 Jan-Mar
TI  - A prescribed walking regimen plus arginine supplementation improves function and 
      quality of life for patients with pulmonary arterial hypertension: a pilot study.
PG  - 2045893217743966
LID - 10.1177/2045893217743966 [doi]
LID - 2045893217743966
AB  - Current evidence suggests that exercise training is beneficial in pulmonary 
      arterial hypertension (PAH). Unfortunately, the standard supervised, 
      hospital-based programs limit patient accessibility to this important 
      intervention. Our proof-of-concept study aimed to provide insight into the 
      usefulness of a prescribed walking regimen along with arginine supplementation to 
      improve outcomes for patients with PAH. Twelve PAH patients (all women) in New 
      York Heart Association (NYHA) functional class (FC) II (n = 7) or III (n = 5) and 
      in stable condition for >/= 3 months were enrolled. Patients performed home- and 
      fitness-center- based walking at 65-75% heart rate (HR) reserve for 45 min, six 
      sessions/week for 12 weeks. Concomitant L-arginine supplementation (6000 mg/day) 
      was provided to maximize beneficial endothelial training adaptations. 
      Cardiopulmonary exercise testing, 6-min walk testing (6MWT), echocardiography, 
      laboratory studies, and quality of life (QoL) survey (SF-36) were performed at 
      baseline and 12 weeks. Eleven patients completed the study (72 session adherence 
      rate = 96 +/- 3%). Objective improvement was demonstrated by the 6MWT distance 
      (increased by 40 +/- 13 m, P = 0.01), VO(2)max (increased by 2 +/- 0.7 mL/kg/min, 
      P = 0.02), time-to-VO(2)max (increased by 2.5 +/- 0.6 min, P = 0.001), VO(2) at 
      anaerobic threshold (increased by 1.3 +/- 0.5 mL/kg/min, P = 0.04), HR recovery 
      (reduced by 68 +/- 23% in slope, P = 0.01), and SF-36 subscales of Physical 
      Functioning and Energy/Fatigue (increased by 70 +/- 34% and 74 +/- 34%, respectively, 
      P < 0.05). No adverse events occurred, and right ventricular function and brain 
      natriuretic peptide levels remained stable, suggesting safety of the 
      intervention. This proof-of-concept study indicates that a simple walking regimen 
      with arginine supplementation is a safe and efficacious intervention for 
      clinically stable PAH patients, with gains in objective function and QoL 
      measures. Further investigation in a randomized controlled trial is warranted.
FAU - Brown, Mary Beth
AU  - Brown MB
AD  - 1 Department of Physical Therapy, Indiana University School of Health and 
      Rehabilitation Sciences, Indianapolis, IN, USA.
AD  - 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, 
      Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 
      USA.
FAU - Kempf, Attie
AU  - Kempf A
AD  - 1 Department of Physical Therapy, Indiana University School of Health and 
      Rehabilitation Sciences, Indianapolis, IN, USA.
FAU - Collins, Catherine M
AU  - Collins CM
AD  - 1 Department of Physical Therapy, Indiana University School of Health and 
      Rehabilitation Sciences, Indianapolis, IN, USA.
FAU - Long, Gary M
AU  - Long GM
AD  - 1 Department of Physical Therapy, Indiana University School of Health and 
      Rehabilitation Sciences, Indianapolis, IN, USA.
FAU - Owens, Matthew
AU  - Owens M
AD  - 1 Department of Physical Therapy, Indiana University School of Health and 
      Rehabilitation Sciences, Indianapolis, IN, USA.
FAU - Gupta, Shikha
AU  - Gupta S
AD  - 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, 
      Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 
      USA.
FAU - Hellman, Yaron
AU  - Hellman Y
AD  - 3 12250 Division of Cardiology, Department of Medicine, Indiana University School 
      of Medicine , Indianapolis, IN, USA.
FAU - Wong, Vincent
AU  - Wong V
AD  - 3 12250 Division of Cardiology, Department of Medicine, Indiana University School 
      of Medicine , Indianapolis, IN, USA.
FAU - Farber, Mark
AU  - Farber M
AD  - 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, 
      Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 
      USA.
FAU - Lahm, Tim
AU  - Lahm T
AD  - 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, 
      Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 
      USA.
AD  - 4 Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pulm Circ
JT  - Pulmonary circulation
JID - 101557243
PMC - PMC5731727
OTO - NOTNLM
OT  - PAH
OT  - aerobic exercise
OT  - cardiopulmonary rehabilitation
OT  - exercise training
OT  - home exercise program
EDAT- 2017/12/05 06:00
MHDA- 2017/12/05 06:01
PMCR- 2017/12/04
CRDT- 2017/12/05 06:00
PHST- 2017/12/05 06:00 [entrez]
PHST- 2017/12/05 06:00 [pubmed]
PHST- 2017/12/05 06:01 [medline]
PHST- 2017/12/04 00:00 [pmc-release]
AID - 10.1177_2045893217743966 [pii]
AID - 10.1177/2045893217743966 [doi]
PST - ppublish
SO  - Pulm Circ. 2018 Jan-Mar;8(1):2045893217743966. doi: 10.1177/2045893217743966.