Effect of L-arginine on cardiac reverse remodeling and quality of life in patients with heart failure

Summary Background & aims Heart failure (HF), as a major cardiac disease, is associated with considerable mortality, morbidities and poor quality of life. The aim of this study was to investigate the effect of L-arginine supplementation on cardiac outcomes and quality of life in patients with ischemic HF. Methods This double-blind randomized controlled clinical trial was conducted in 50 patients with ischemic HF. Patients were randomly assigned to receive either 3 gr/d L-arginine or placebo, for 10 weeks. Cardiac function (based on echocardiography and six-minute walk test), blood pressure, and quality of life (based on the Minnesota living with heart failure questionnaire) were assessed. Results The results showed significant improvements in ejection fraction (-6.5±8.7 vs. -0.7±7.8 %, P=0.037), left ventricular function (P=0.043), diastolic dysfunction (P=0.01) and marginally improvement in changes of left ventricular dimension during diastole (LVDd) (4±6 vs. 0.3±6.9 mm, P=0.065) in the L-arginine compared to the placebo group. At the end of the study, physical aspect (5.7±3.3 vs. 1.2±6.1, P=0.002) and total score (10±6.7 vs. 4.1±9.4, P=0.011) of quality of life improved significantly in the L-arginine compared with the placebo group. Additionally, pre-to post-values of diastolic blood pressure, mean arterial pressure, LVDd, LV ejection fraction, left ventricular function, diastolic dysfunction as well as physical and total scores of quality of life improved significantly within the intervention, but not the placebo, group (all P Conclusion This study showed that 3 gr/d L-arginine supplementation for 10 weeks could improve cardiac recovery and function, and quality of life in patients with HF. This study was registered at the Iranian Clinical Trial Registration Center ( www.irct.ir ) with IRCT20170202032367N4 code.