Training-induced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: An extra benefit of water-based exercises?

Laurent Mourot, Daline Teffaha, Malika Bouhaddi, Fawzi Ounissi, Philippe Vernochet, Benoit Dugue, Catherine Monpère, Jacques Regnard

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)


Rehabilitation programs involving immersed exercises are more and more frequently used, with severe cardiac patients as well. This study investigated whether a rehabilitation program including water-based exercises has additional effects on the cardiovascular system compared with a traditional land-based training in heart disease patients. Twenty-four male stable chronic heart failure patients and 24 male coronary artery disease patients with preserved left ventricular function participated in the study. Patients took part in the rehabilitation program performing cycle endurance exercises on land. They also performed gymnastic exercises either on land (first half of the participants) or in water (second half). Resting plasma concentration of nitric oxide metabolites (nitrate and nitrite) and catecholamine were evaluated, and a symptom-limited exercise test on a cycle ergometer was performed before and after the rehabilitation program. In the groups performing water-based exercises, the plasma concentration of nitrates was significantly increased (P = 0.035 for chronic heart failure and P = 0.042 for coronary artery disease), whereas it did not significantly change in the groups performing gymnastic exercise on land. No changes in plasma catecholamine concentration occurred. In every group, the cardiorespiratory capacity of patients was significantly increased after rehabilitation. The water-based exercises seemed to effectively increase the basal level of plasma nitrates. Such changes may be related to an enhancement of endothelial function and may be of importance for the health of the patients.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalEuropean Journal of Preventive Cardiology
Issue number2
Publication statusPublished - 1 Jan 2009
Externally publishedYes


  • cardiac disease
  • cardiovascular system
  • head-out water immersion
  • nitric oxide
  • rehabilitation

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

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