Delayed preconditioning-mimetic actions of exercise or nitroglycerin do not affect haemodynamics and exercise performance in trained or sedentary individuals

Abstract

Nitroglycerin induces the so-called second window of protection (SWOP), which alleviates myocardial damage and stunning after ischaemia/reperfusion. To determine whether myocardial performance during exercise is improved in the second window of protection, we studied the haemodynamic responses of 12 trained and 11 sedentary individuals during a sequence of maximal tests on a cycle ergometer. A baseline test (basal test) was followed by a second effort performed during the second window of protection (exercise-SWOP test). Haemodynamics was also evaluated after pharmacologically induced SWOP 48 h after transdermal administration of 10 mg of nitroglycerin (pharmacologically induced SWOP test). The exercise-SWOP and pharmacologically induced SWOP tests were separated by a 1-week washout period. Endothelial-dependent vasodilatation after nitroglycerin pre-treatment was also assessed in five sedentary individuals to determine whether nitrate donors could affect vascular function. We found that nitroglycerin pre-treatment did not induce any improvement in haemodynamics in either trained or sedentary individuals, since maximum values of workload, heart rate, stroke volume, cardiac output, myocardial contractility, and double product were similar between the exercise-SWOP and pharmacologically induced SWOP tests in both groups. Furthermore, nitroglycerin pre-treatment did not alter flow-mediated dilation during pharmacologically induced SWOP. Although nitroglycerin pre-treatment alleviates post-ischaemic myocardial stunning, our results suggest that it does not affect the myocardial performance of healthy individuals during exercise performed in the second window of protection, independently of the training status of the individuals. Moreover, nitroglycerin pre-treatment does not ameliorate endothelial function.

Keywords:

• Cardiac output
• exercise
• myocardial contractility
• nitroglycerin

Acknowledgements

This study was supported by the University of Cagliari, University of Torino, Regione Piemonte and Italian Ministry of Research. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.