Dietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fraction

Endothelial dysfunction and reduced nitric oxide (NO) signaling are key abnormalities leading to skeletal muscle oxygen delivery-utilization mismatch and poor physical capacity in patients with heart failure with reduced ejection fraction (HFrEF). Oral inorganic nitrate supplementation provides an exogenous source of NO that may enhance locomotor muscle function and oxygenation with consequent improvement in exercise tolerance in HFrEF. Thirteen patients (left ventricular ejection fraction 0.05). Similarly, there were no significant differences in central hemodynamics, arterial blood pressure, pulmonary oxygen uptake kinetics, skeletal muscle oxygenation, or blood lactate concentration from rest to low- or high-intensity exercise between conditions. Oral inorganic nitrate supplementation with concentrated beetroot juice did not present with beneficial effects on central or peripheral components of the oxygen transport pathway thereby failing to improve exercise tolerance in patients with moderate HFrEF.Senate Advisory Research Committee (SARC) Postdoctoral Fellow Support ProgramDepartment of Medicine, Queen's UniversityQueens Univ, Dept Med, Div Respirol, Lab Clin Exercise Physiol, Kingston, ON, CanadaUniv Fed Sao Paulo, Dept Med, Div Resp, Pulm Funct & Clin Exercise Physiol Unit, Sao Paulo, BrazilQueens Univ, Sch Kinesiol & Hlth Studies, Human Vasc Control Lab, Kingston, ON, CanadaQueens Univ, Dept Med, Div Cardiol, Kingston, ON, CanadaQueens Univ, Dept Med, Div Respirol, Resp Investigat Unit, Kingston, ON, CanadaDepartment of Medicine, Respiratory Division, Pulmonary Function and Clinical Exercise Physiology Unit, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, BrazilWeb of Scienc