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OtherCardiovascular

L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic

Pasquale Mone, Raffaele Izzo, Giuseppe Marazzi, Maria Virginia Manzi, Paola Gallo, Giuseppe Campolongo, Luca Cacciotti, Domenico Tartaglia, Giuseppe Caminiti, Fahimeh Varzideh, Gaetano Santulli and Valentina Trimarco
Journal of Pharmacology and Experimental Therapeutics March 26, 2022, JPET-AR-2022-001149; DOI: https://doi.org/10.1124/jpet.122.001149
Pasquale Mone
1AECOM, United States
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Raffaele Izzo
2Federico II University, Italy
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Giuseppe Marazzi
3San Raffaele, Italy
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Maria Virginia Manzi
2Federico II University, Italy
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Paola Gallo
2Federico II University, Italy
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Giuseppe Campolongo
4Ospedale San Carlo, Italy
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Luca Cacciotti
5Ospedale G. Vannini, Italy
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Domenico Tartaglia
6ASL AV, United States
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Giuseppe Caminiti
3San Raffaele, Italy
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Fahimeh Varzideh
7Montefiore University Hospital, United States
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Gaetano Santulli
8Albert Einstein College of Medicine, United States
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  • ORCID record for Gaetano Santulli
  • For correspondence: gsantulli001@gmail.com
Valentina Trimarco
2Federico II University, Italy
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Abstract

Cardiac rehabilitation (CR) following acute myocardial infarction (AMI) improves physical capacities and decreases hospitalizations and cardiovascular mortality. L-Arginine is the substrate used by nitric oxide (NO) synthase (NOS) to generate NO and it has been shown to exert its beneficial effects on endothelium driving vasodilatation, reducing inflammation, and ameliorating physical function. We hypothesized that L-Arginine could enhance physical capacities in patients who underwent CR after AMI. We designed a study aimed to assess the effects of L-arginine administration on the physical capacity of patients who underwent coronary revascularization after AMI. The trial was carried out amid the COVID-19 pandemic. Patients were assigned, with a 2:1 ratio, to add to their standard therapy 1 bottle containing 1.66 g of L-arginine or 1 bottle of identical aspect apart from not containing L-arginine, twice a day orally for 3 weeks. Patients performed a 6-minute walking test (6MWT) and were assessed their Borg modified 0-10 rating of perceived exertion (BRPE) before starting and at the end of the treatment. Seventy-five patients receiving L-Arginine, and thirty-five receiving placebo successfully completed the study. The 6MWT distance increased significantly in the L-Arginine group compared to both baseline and placebo (p<0.0001). Additionally, we observed a significant improvement in the BRPE in patients treated with L-arginine but not in the placebo group. Taken together, our data indicate that L-arginine potentiates the response to CR, independently of age, sex, baseline functional capacity, and comorbid conditions.

Significance Statement This study shows for the first time that oral supplementation of L-arginine potentiates the response to cardiac rehabilitation after myocardial infarction and cardiac revascularization. Indeed, we observed a significant improvement in two fundamental parameters, namely, the 6-minute walking test and the Borg modified 0-10 rating of perceived exertion. Strikingly, the beneficial effects of L-arginine were independent from age, sex, comorbid conditions, and baseline functional capacity.

  • cardiac ischemia
  • cardiovascular disease
  • cardiovascular drugs
  • heart/cardiac
  • L-arginine
  • skeletal muscle
  • Copyright © 2020 American Society for Pharmacology and Experimental Therapeutics
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Journal of Pharmacology and Experimental Therapeutics: 384 (2)
Journal of Pharmacology and Experimental Therapeutics
Vol. 384, Issue 2
1 Feb 2023
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OtherCardiovascular

L-Arginine improves post-infarction physical function

Pasquale Mone, Raffaele Izzo, Giuseppe Marazzi, Maria Virginia Manzi, Paola Gallo, Giuseppe Campolongo, Luca Cacciotti, Domenico Tartaglia, Giuseppe Caminiti, Fahimeh Varzideh, Gaetano Santulli and Valentina Trimarco
Journal of Pharmacology and Experimental Therapeutics March 26, 2022, JPET-AR-2022-001149; DOI: https://doi.org/10.1124/jpet.122.001149

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OtherCardiovascular

L-Arginine improves post-infarction physical function

Pasquale Mone, Raffaele Izzo, Giuseppe Marazzi, Maria Virginia Manzi, Paola Gallo, Giuseppe Campolongo, Luca Cacciotti, Domenico Tartaglia, Giuseppe Caminiti, Fahimeh Varzideh, Gaetano Santulli and Valentina Trimarco
Journal of Pharmacology and Experimental Therapeutics March 26, 2022, JPET-AR-2022-001149; DOI: https://doi.org/10.1124/jpet.122.001149
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