Neuromuscular fatigability in individuals with heart failure
Research type
Research Study
Full title
The influence of active muscle mass and nitrate supplementation on fatigability in individuals with heart failure
IRAS ID
340538
Contact name
C Brownstein
Contact email
Sponsor organisation
Newcastle upon Tyne Hopsitals NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Chronic heart failure (CHF) is a complex clinical syndrome associated with structural and functional abnormalities, which lead to reduced cardiac output at rest and/or in response to stress. Exercise intolerance is a hallmark symptom of chronic heart failure (CHF) and is associated with reduced quality of life as well as being a strong prognostic indicator. Research in recent years has attempted to better understand the aetiology of exercise intolerance to provide therapeutic targets to improve physical capacity and quality of life. An important determinant of exercise intolerance is neuromuscular fatigability, defined as the reduction in neuromuscular function measured after exercise of a discrete time period. At present, few studies have assessed neuromuscular fatigability in individuals with CHF, and none have done so in response to dynamic, whole-body exercise (e.g. cycling). Research characterising fatigability and determining its underlying mechanisms can help better understand the aetiology of exercise intolerance, and in turn provide therapeutic targets aimed at improving physical capacity and quality of life in individuals with CHF.
One potential strategy to attenuate fatigability is through nitrate supplementation (i.e. beetroot juice). Specifically, the consumption of nitrate-rich beetroot juice promotes increased nitric oxide bioavailability, which in turn can enhance local perfusion and oxygenation, skeletal muscle contractility, and muscle efficiency. Given that individuals with CHF have impaired nitric oxide bioavailability and reduced local perfusion and oxygenation, which likely contribute to impaired fatigability, nitric oxide represents an attractive intervention to mitigate fatigability and improve exercise tolerance. To date, no study has assessed the effect of nitrate supplementation on neuromuscular fatigability in individuals with CHF.
REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
24/EE/0077
Date of REC Opinion
4 Jun 2024
REC opinion
Further Information Favourable Opinion