Abstract
Cardiac transplant patients manifest several haemodynamic changes as well as altered peripheral responses to exercise which may disrupt body fluid regulation. This study examined the effect on an endurance training programme on the exercise-induced hydromineral endocrine responses of heart transplant patients. Seven patients underwent a square-wave exercise test before and after a 6-week training programme. The tests were performed at the same absolute intensity but, during training, the workload was increased to maintain the same relative exercise intensity. Pretraining results were compared to those obtained from agematched controls. Training improved physical capacity, producing a significant increase in maximal tolerated power and workload between the first and last training session (P < 0.05, P < 0.001, respectively). Haematocrit and osmolality were increased in both groups at the end of exercise (P < 0.01) but changes observed post-training did not differ from pretraining values. Apart from atrial natriuretic peptide (ANP), which showed significantly higher concentrations at rest and during exercise (P < 0.01), the changes in hydromineral hormones of the patients resembled those of the controls. Basal plasma renin activity (PRA) was slightly raised prior to training (P < 0.07) compared to the controls and post-training. For both PRA and aldosterone, a significant training effect was revealed when both the exercise-stimulated increase and postexercise decline were considered (P < 0.05), possibly reflecting lower noradrenaline concentrations. Training had no effect on either basal or exercise stimulated ANP levels, which is compatible with the theory that ANP regulation is largely under mechanical rather than sympathetic nervous system control. Mean arginine vasopressin concentrations in the patients were not increased, possibly due to inhibitory effects of immunosuppressive glucocorticoids combined with the large variation in response observed, particularly for the untrained patients. In summary, these results showed that despite cardiac denervation, the heart transplant patients demonstrated effective body fluid regulatory endocrine responses during exercise and that although training produced substantial improvement in their physical capacity, it was accompanied by only subtle changes in hydromineral hormones.
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Saini, J., Brandenberger, G., Wittersheim, G. et al. Training effects on the hydromineral endocrine responses of cardiac transplant patients. Eur J Appl Physiol 70, 226–233 (1995). https://doi.org/10.1007/BF00238568
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DOI: https://doi.org/10.1007/BF00238568