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Influence of glutamine on the effect of resistance exercise on cardiac ANP in rats

Influência da glutamina nos efeitos do treinamento resistido no ANP cardíaco em ratos

Influencia de la glutamina sobre los efectos del entrenamiento de resistencia sobre la ANP cardíaca en ratas

Abstracts

Various nutritional supplements (herbs, vitamins, and micronutrients) improve responses and adaptations to resistance exercise. ANP is a heart hormone that contributes to fluid, electrolyte and blood pressure homeostasis through its natriuretic and vasodilative actions. In the present study, the adaptation of ANP in response to resistance exercise was investigated in rats supplemented with glutamine for five weeks. The results showed that supplementation with glutamine did not influence the number of ANP granules per atrial cardiocyte in sedentary animals. In exercised-trained rats, the number and diameter of the granules was significantly higher in comparison with the control group and in exercised animals supplemented with glutamine there was significant increase in the number and diameter of ANP granules compared with controls. Altogether, these data indicated that in resistance exercise rats, glutamine significantly enhances cardiac ANP thus implicating the beneficial effects of glutamine supplementation to the ANP system.

Glutamine; Resistance exercise; ANP; Rat


Vários suplementos nutricionais (ervas, vitaminas e micronutrientes) melhoram as respostas e adaptações ao exercício resistido. O ANP é um hormônio cardíaco que contribui para a homeostase de líquidos, eletrólitos e controle da pressão arterial através de suas ações natriurética e vasodilatadora. No presente estudo, a adaptação do ANP em resposta ao treinamento resistido foi investigada em ratos suplementados com glutamina durante cinco semanas. Os resultados mostraram que a suplementação com glutamina não influenciou o número de grânulos de ANP por cardiomiócito em animais sedentários. Em ratos treinados, o número e o diâmetro dos grânulos foi significativamente maior em comparação com o grupo controle e nos animais treinados e suplementados com glutamina houve um aumento significativo no número e diâmetro dos grânulos de ANP comparativamente com os controles. Em conjunto, estes dados indicam que, nos ratos submetidos ao treinamento resistido, a glutamina aumentou significativamente os níveis de ANP cardíaco, mostrando assim, os efeitos benéficos da suplementação com glutamina para o sistema de ANP.

Glutamina; Treinamento resistido; ANP; Rato


Varios suplementos nutricionales (hierbas, vitaminas y micronutrientes) mejoran las respuestas y adaptaciones al ejercicio de resistencia. El ANP es una hormona cardíaca que contribuye a la homeostasis de fluidos, electrolitos y de control de la presión arterial a través de sus acciones vasodilatadora y natriurética. En el presente estudio, se investigó la adaptación de la ANP en respuesta al entrenamiento de resistencia en ratones suplementados con glutamina durante cinco semanas. Los resultados mostraron que la suplementación de glutamina no influyó en el número de gránulos de ANP por cardiomiocito en animales sedentarios. En ratas entrenadas, el número y el diámetro de los gránulos fue significativamente mayor en comparación con el grupo control y en los animales entrenados y suplementados con glutamina hubo un aumento significativo en el número y diámetro de los gránulos de ANP en comparación con los controles. En conjunto, estos datos indican que en ratones sometidos a entrenamiento de resistencia, la glutamina aumentó significativamente el nivel de ANP cardiaco mostrando de esta manera los efectos beneficiosos de la administración de glutamina para el sistema de ANP.

Glutamina; Entrenamiento de resistencia; ANP; Ratón


Introduction

Several factors contribute to the beneficial effects of exercise in maintaining cardiovascular homeostasis (GutkowskaKraemer WJ, Hatfield DL, Spiering BA, Vingren JL, Fragala MS, Ho J, et al. Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance exercise. Eur J Appl Physiol 2007;101:637-46. et al., 2007; Agarwal, 2012Agarwal SK. Cardiovascular benefits of exercise. Int J Gen Med 2012;5:541-5.; Rowland and Unnithan, 2013Rowland T, Unnithan V. Myocardial inotropic response to progressive exercise in healthy subjects: a review. Curr Sports Med Rep 2013;12:93-100.). ANP is a heart hormone that contributes to fluid, electrolyte, and blood pressure homeostasis through its natriuretic and vasodilative actions. It was shown in humans and animals that exercise provokes increased synthesis of ANP thus maintaining adequate levels for the optimal control of blood pressure (Tanaka et al., 1986Tanaka H, Shindo M, Gutkowska J, Kinoshita A, Urata H, Ikeda M, et al. Effect of acute exercise on plasma immunoreactive atrial natriuretic factor. Life Sci 1986;39:1685-93.; Guezennec et al., 1989Guezennec CY, Fournier E, Galen FX, Lartigues M, Louisy F, Gutkowska J. Effects of physical exercise and anti-G suit inflation on atrial natriuretic factor plasma level. Eur J Appl Physiol 1989;5:500-7.; Barletta et al., 1998Barletta G, Stefani L, Del Bene R, Fronzaroli C, VecchiarinoS, Lazzeri C, et al. Effects of exercise on natriuretic peptides and cardiac function in man. Int J Cardiol 1998;65:217-25.; Ohba et al., 2001Ohba H, Takada H, Musha H, Nagashima J, Mori N, Awaya T, et al. Effects of prolonged strenuous exercise on plasma levels of atrial natriuretic peptide and brain natriuretic peptide in healthy men. Am Heart J 2001;141:751-8.; Edwards, 2012Edwards JG. Swim training increases ventricular atrial natriuretic factor (ANF) gene expression as an early adaptation to chronic exercise. Life Sci 2012;70:2753-68.; Gutkowska et al., 2007; Wiesner et al., 2010Wiesner S, Birkenfeld AL, Engeli S, Haufe S, Brechtel L, Wein J, et al. Neurohumoral and metabolic response to exercise in water. Horm Metab Res 2010;42:334-9.; Endlich et al., 2011Endlich PW, Firmes LB, Gonçalves WL, Gouvea AS, Moysés MR, Bissoli NS, et al. Involvement of the atrial natriuretic peptide in the reduction of arterial pressure induced by swimming butnot by running training in hypertensive rats. Peptides 2011;32:1706-12.).

Because of the critical functions of hormones, researchers have investigated various methods to enhance the exercise–endocrine interaction. For instance, feeding subjects before and/or immediately after resistance exercise alters hormone response (Kraemer and Volek, 1998Kraemer WJ, Volek JS. Hormonal responses to consecutive days of heavy resistance exercise with or without nutritional supplementation. J Appl Physiol 1998;85:1544-55.; Kraemer et al., 2007Kraemer WJ, Hatfield DL, Spiering BA, Vingren JL, Fragala MS, Ho J, et al. Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance exercise. Eur J Appl Physiol 2007;101:637-46.; Gulli et al., 2012Gulli RA, Tishinsky JM, MacDonald T, Robinson LE, Wright DC, Dyck DJ. Exercise restores insulin, but not adiponectin, response in skeletal muscle of high-fat fed rodents. Am J Physiol Regul Integr Comp Physiol 2012;303:R1062-70.). In addition to feeding, various nutritional supplements (herbs, vitamins, and micronutrients) improve responses and adaptations to resistance exercise. Nutritional supplements such as creatine, ɩ-carnitine and ɩ-glutamine positively affect strength development and resistance exercise recovery (Williams et al., 2002Williams AG, Ismail AN, Sharma A, Jones DA. Effects of resistance exercise volume and nutritional supplementation on anabolic and catabolic hormones. Eur J Appl Physiol 2002;86:315-21.; Kraemer and Volek, 1998Kraemer WJ, Volek JS. Hormonal responses to consecutive days of heavy resistance exercise with or without nutritional supplementation. J Appl Physiol 1998;85:1544-55.; Kraemer et al., 2007Kraemer WJ, Hatfield DL, Spiering BA, Vingren JL, Fragala MS, Ho J, et al. Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance exercise. Eur J Appl Physiol 2007;101:637-46.; Rawson and Volek, 2003Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res 2003;17:822-31.; Volek and Rawson, 2002Volek JS, Rawson ES. Scientific basis and practical aspects of creatine supplementation for athletes. Eur J Clin Nutr 2002;56:585-92.; Cermak et al., 2012Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr 2012;96:1454-64.; Wax et al., 2012Wax B, Kavazis AN, Webb HE, Brown SP. Acute L-arginine alpha ketoglutarate supplementation fails to improve muscular performancein resistance trained and untrained men. J Int Soc Sports Nutr 2012;9:1-6.). One of these nutritional supplements, glutamine have been widely used by athletes (Mero et al., 2009Mero A, Leikas A, Knuutinen J, Hulmi JJ, Kovanen V. Effect of strength training session on plasma amino acid concentration following oral ingestion of leucine, BCAAs or glutamine in men. Med Sci Sports Exerc 2009;105:215-23.). However, the effects of this supplement in ANP levels in practitioners of resistance exercise are not known. Therefore, utilizing the rat as an animal model the following study was undertaken to test the hypothesis that glutamine stimulates the cardiac hormone ANP in chronic resistance exercise practitioners.

Materials and methods

Animals

Male Wistar rats weighing 290±20g (3 months old) were obtained from the Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil. The rats were maintained at 23°C under a cycle of 12h light/12h darkness. The animals fed with a standard diet were divided into the following groups of five animals each: sedentary (S), exercised (E), sedentary supplemented with glutamine (SG) and exercised supplemented with glutamine (EG). Non-supplemented rats received 3ml of saline (0.1mol/l citrate, pH 4.5) as placebo.

Oral ɩ-glutamine supplementation

An aqueous solution of ɩ-glutamine was given to rats by gavage (1gkg−1 body weight in 3ml saline) 1h before the exercise session according to Shewchuk et al. (1997)Shewchuk LD, Baracos VE, Field CJ. Dietary L-glutamine supplementation reduces the growth of the Morris hepatoma in exercise-trained and sedentary rats. J Nutr 1997;127:158-66. and Lagranha et al. (2004)Lagranha CJ, Senna SM, de Lima TM, Silva E, Doi SQ, Curi R, et al. Beneficial effect of glutamine on exercise-induced apoptosis of rat neutrophils. Med Sci Sports Exerc 2004;36:210-7.. Glutamine solution was freshly prepared before administration to avoid glutamine hydrolysis.

Exercise training

Rats in the E and EG groups were trained to climb a 1.1m vertical (80° incline) ladder with weights tied to their tail (Hornberger and Farrar, 2004Hornberger TAJ, Farrar RP. Physiological hypertrophy of the FHL muscle following 8 weeks of progressive resistance exercise in the rat. Can J Appl Physiol 2004;29:16-31.), five days per week, for five weeks. Each training session consisted of six climbs. The weight carried during each session was progressively increased. Over the course of five weeks, the maximal weight carried by the rats was 50% of their body weight. This load was maintained throughout the rest of the period of experiment. The rats in the S and SG groups were placed on a stationary treadmill for 10min daily. The body weight (BW) was measured at the beginning and at the end of the experiment. Handling of animals was approved by the University Ethics Committee, in accordance with the International Guiding Principles for Biomedical Research involving Animals.

Preparation for electron microscopy

At the end of the experiment, each animal was anesthetized with intraperitoneal Pentobarbital sodium (3mg/100g body weight) and then killed. The animals were heparinized prior to fixation to optimize perfusion-fixation. The atria were perfused through the left and right ventricles at a constant pressure of 80mmHg, using 0.1M cacodylate buffer (3min) followed by 2.5% glutaraldehyde solution diluted in cacodylate buffer. Next, the heart was isolated and weighed. The right atrium was isolated and divided into slices approximately 3mm wide and 5mm long. These tissue slices were post-fixed in osmium tetroxide in sodium cacodylate buffer for 1h. The tissue was dehydrated in graded alcohols, embedded in Epon resin, and sectioned so that the cardiocytes were cut in longitudinal section. Thin sections for transmission electron microscopy were stained with uranyl acetate, and lead citrate (Mifune et al., 2004Mifune H, Honda J, Takamori S, Sugiyama F, Yagami K, Suzuki S. A-type natriuretic peptide level in hypertensive transgenic mice. Exp Anim 2004;53:11-9.).

Ultrastructural morphometry

Two randomly chosen blocks from each atrium, in which the cardiocytes were cut in longitudinal section were used for quantitative analysis. The ultra thin sections were placed on a copper grid and 10 randomly chosen fields per block were selected for micrographs taken with a Jeol transmission electron microscope. The number and sizes of secretory granules were obtained according to the method of Cantin et al. (1979)Cantin M, Timm-Kennedy M, El-Khatib E, Huet M, Yunge L. Ultrastructural cytochemistry of atrial muscle cells: comparative study of specific granules in right and left atrium of various animal species. Anat Rec 1979;193:55-70.. Five electron micrographs per animal, chosen by systematic random sampling of squares were taken at a final magnification of 7500× and the number of granules/cardiocyte was determined. Diameters of all granules present in each field were determined in another five micrographs per animal at a final magnification of 15,000×. In both cases, a computerized program (Axio Vision, Zeiss) was used.

Statistical analysis

All results are means±SE. Data was performed using one-way analysis of variance (ANOVA) and multiple comparison procedure was performed using Tukey's test with p<0.05 as the level of significance.

Results

Heart weight

As shown in Fig. 1, no difference in heart weight was seen between the groups S (1.1±0.2g) and SG (1.1±0.1g) and between the groups E (1.5±0.2g) and EG (1.5±0.1g). However, in E and EG the heart showed significant hypertrophy compared to S (p<0.05).

Figure 1
Heart weight of S, SG, E and EG rats. *Significant vs. S and SG.

Ultrastructure

The ANP granules were mainly located in the perinuclear region and were variable in number (Fig. 1) and size (Fig. 2). The number of granules was increased in E and EG compared with S and SG rats (Figs. 2 and 3).

Figure 2
Electron micrographs of the right atrial cardiocytes in S (a), SG (b), E (c) and EG (d) rats. In atrial cardiocytes, ANP-granules (arrows) are variable in number and are mainly located in the perinuclear region. The number of granules in E (c) and EG (d) rats is higher than in S (a) and SG (b). Bar: 2μ m. N - Nucleus.
Figure 3
Electron micrographs of the right atrial cardiocytes in S (a), SG (b), E (c) and EG (d) rats. It can be seen that in all groups ANP-granules (arrows) are variable in size. In E and EG rats, the sizes of the granules are higher than in S and SG. Bar: 1μ m. N - Nucleus.

Ultrastructural morphometry

The number of granules/cardiocyte is shown in Fig. 4 and the diameter of the granules is shown in Fig. 5. The number of granules/cardiocyte was significantly higher in E (62±3) and in EG (72±4) compared to SG (56±4) and S rats (50±3) (in all cases, p<0.05). The number of granules/cardiocyte was significantly higher in EG than in E rats (p<0.05). No significant difference was observed in the number of granules/cardiocyte between SG and S rats (p>0.05). The diameter of granules was significantly higher in EG (320±24nm) and E (260±10nm) rats compared to S rats (212±12nm) and SG (218±8nm) rats (p<0.05). The diameter of granules was significantly higher in EG than in E rats (p<0.05).

Figure 4
Number of ANP-granules/cardiocyte in the rightatria from S, SG, E and EG rats. *Significant vs. S, SG and EG groups (p < 0.05). ** Significant vs. S and SG groups (p < 0.05).
Figure 5
Diameter of ANP-granules (nm) in the right atrialcardiocytes in S, SG, E and EG rats. *Significant vs. S, SG and EG groups (p < 0.05). ** Significant vs. S and SG groups (p < 0.05).

Discussion

There are three major findings in this work. First, glutamine supplementation for five weeks had no influence on the levels of ANP in atrial cardiocytes. Second, chronic resistance exercise increased significantly the levels of ANP in atrial cardiocytes and third, glutamine enhances the effects of resistance exercise on the levels of ANP in atrial cardiocytes.

Glutamine is an important energy source (nitrogen and carbon) for synthesis of other molecules such as nucleotides, adenosine triphosphate (ATP) and other amino acids (Fontana et al., 2003Fontana KE, Valdes H, Valdissera V. Glutamina como suplemento ergogênico. Rev Bras Cienc Mov 2003;11:91-6.). Glutamine is also necessary for the absorption of fluids and electrolytes and for the regulation of nitrogen balance (Walsh et al., 1998Walsh NP, Blannin AK, Clark AM, Cook L, Robson PJ, Gleeson M, et al. The effects of high-intensity intermittent exercise on the plasma concentrations of glutamine and organic acids. Eur J Appl Physiol 1998;77:434-8.). In the present study, animals receiving glutamine did not exhibit any significant enhancement of cardiac ANP levels compared with sedentary controls, indicating that glutamine had no effect on the number of ANP granules by cardiocytes.

The present study demonstrated a significant increase in the number of cardiac ANP granules in rats with exercise-training compared to the S group. This result is in agreement with that of Gutkowska et al. (2007) in showing that chronic exercise augmented ANP expression in the right atrium. It is possible that resistance exercise promotes an increase in levels of ANP in cardiomyocytes due to the necessity of greater release of this hormone to the plasma during exercise. According to Gutkowska et al. (2007) the beneficial effects of exercise may be due, at least in part, to activation of cardiac oxytocin peptide receptors and subsequent enhancement of ANP synthesis and release although a direct effect of exercise on the ANP cannot be excluded. This conclusion emerged from studies showing that activation of cardiac oxytocin receptor is coupled with ANP release (Gutkoswska et al., 1997Gutkoswska J, Jankowski M, Lambert C, Mukaddam-Daher S, ZinggHH, McCann SM. Oxytocin releases atrial natriuretic peptide by combining with oxytocin receptors in the heart. Proc Natl Acad Sci USA 1997;94:11704-9.). The physiological action of ANP is conveyed by binding to particulate GC-coupled cell surface functional receptor GC-A which activation promotes the intracellular generation of cGMP (Potter et al., 2006Potter LR, Abbey-Rosch S, Dickey DM. Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions. Endocr Rev 2006;27:47-72.; Gutkowska et al., 2007).

Although several studies have been conducted showing the positive effects of ingesting supplements on resistance exercise (Kerksick et al., 2006Kerksick CM, Rasmussen CJ, Lancaster SL, Magu B, Smith P, Melton C, et al. The effects of protein and amino acid supplementation on performance and training adaptations during ten weeks of resistance training. J Strength Cond Res 2006;20:643-53.) we did not find in literature studies showing the effects of glutamine on the ANP cardiocytes. Glutamine is especially abundant in skeletal muscle tissue. Following intense exercise, intramuscular glutamine decreases and there is an increased uptake of glutamine in the liver, kidney and intestine, to ensure synthesis of glucose and buffering acidosis. Thus, the plasma glutamine concentration decreased significantly, causing the blood amount is not sufficient for uptake and utilization by the various tissues that depend on (Walsh et al., 1998Walsh NP, Blannin AK, Clark AM, Cook L, Robson PJ, Gleeson M, et al. The effects of high-intensity intermittent exercise on the plasma concentrations of glutamine and organic acids. Eur J Appl Physiol 1998;77:434-8.). Glutamine supplementation promotes the maintenance of its plasmatic concentration, improve the hydration of skeletal muscle and contribute as a substrate for gluconeogenesis resulting in increased muscle cell volume (Antonio and Street, 2003Antonio J, Street C. Glutamine: a potentially useful supplement for athletes. Can J Appl Physiol 2003;24:1-14.; Fontana et al., 2003Fontana KE, Valdes H, Valdissera V. Glutamina como suplemento ergogênico. Rev Bras Cienc Mov 2003;11:91-6.; Waddell and Fredricks, 2005Waddell D, Fredricks K. Effects of glutamine supplement on the skeletal muscle contractile force of mice. Am J Undergr Res 2005;4:11-8.). Possibly, these effects also occur in heart muscle which may have influenced the increase of the levels of ANP in cardiocytes from rats supplemented with glutamine and submitted to exercise.

Conclusion

Glutamine supplementation did not improve ANP production by the cardiocytes but when associated with resistance-training it potentiates the increased cardiac ANP levels promoted by exercise.

References

  • Agarwal SK. Cardiovascular benefits of exercise. Int J Gen Med 2012;5:541-5.
  • Antonio J, Street C. Glutamine: a potentially useful supplement for athletes. Can J Appl Physiol 2003;24:1-14.
  • Barletta G, Stefani L, Del Bene R, Fronzaroli C, VecchiarinoS, Lazzeri C, et al. Effects of exercise on natriuretic peptides and cardiac function in man. Int J Cardiol 1998;65:217-25.
  • Cantin M, Timm-Kennedy M, El-Khatib E, Huet M, Yunge L. Ultrastructural cytochemistry of atrial muscle cells: comparative study of specific granules in right and left atrium of various animal species. Anat Rec 1979;193:55-70.
  • Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr 2012;96:1454-64.
  • Edwards JG. Swim training increases ventricular atrial natriuretic factor (ANF) gene expression as an early adaptation to chronic exercise. Life Sci 2012;70:2753-68.
  • Endlich PW, Firmes LB, Gonçalves WL, Gouvea AS, Moysés MR, Bissoli NS, et al. Involvement of the atrial natriuretic peptide in the reduction of arterial pressure induced by swimming butnot by running training in hypertensive rats. Peptides 2011;32:1706-12.
  • Fontana KE, Valdes H, Valdissera V. Glutamina como suplemento ergogênico. Rev Bras Cienc Mov 2003;11:91-6.
  • Gulli RA, Tishinsky JM, MacDonald T, Robinson LE, Wright DC, Dyck DJ. Exercise restores insulin, but not adiponectin, response in skeletal muscle of high-fat fed rodents. Am J Physiol Regul Integr Comp Physiol 2012;303:R1062-70.
  • Gutkoswska J, Jankowski M, Lambert C, Mukaddam-Daher S, ZinggHH, McCann SM. Oxytocin releases atrial natriuretic peptide by combining with oxytocin receptors in the heart. Proc Natl Acad Sci USA 1997;94:11704-9.
  • Gutkowska J, Paquette A, Wang D, Lavoie JM, Jankowski M. Effect of exercise training on cardiac oxytocin and natriuretic peptide systems in ovariectomized rats. Am J Physiol Regul Integr Comp Physiol 2007;293:267-75.
  • Guezennec CY, Fournier E, Galen FX, Lartigues M, Louisy F, Gutkowska J. Effects of physical exercise and anti-G suit inflation on atrial natriuretic factor plasma level. Eur J Appl Physiol 1989;5:500-7.
  • Hornberger TAJ, Farrar RP. Physiological hypertrophy of the FHL muscle following 8 weeks of progressive resistance exercise in the rat. Can J Appl Physiol 2004;29:16-31.
  • Kerksick CM, Rasmussen CJ, Lancaster SL, Magu B, Smith P, Melton C, et al. The effects of protein and amino acid supplementation on performance and training adaptations during ten weeks of resistance training. J Strength Cond Res 2006;20:643-53.
  • Kraemer WJ, Volek JS. Hormonal responses to consecutive days of heavy resistance exercise with or without nutritional supplementation. J Appl Physiol 1998;85:1544-55.
  • Kraemer WJ, Hatfield DL, Spiering BA, Vingren JL, Fragala MS, Ho J, et al. Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance exercise. Eur J Appl Physiol 2007;101:637-46.
  • Lagranha CJ, Senna SM, de Lima TM, Silva E, Doi SQ, Curi R, et al. Beneficial effect of glutamine on exercise-induced apoptosis of rat neutrophils. Med Sci Sports Exerc 2004;36:210-7.
  • Mero A, Leikas A, Knuutinen J, Hulmi JJ, Kovanen V. Effect of strength training session on plasma amino acid concentration following oral ingestion of leucine, BCAAs or glutamine in men. Med Sci Sports Exerc 2009;105:215-23.
  • Mifune H, Honda J, Takamori S, Sugiyama F, Yagami K, Suzuki S. A-type natriuretic peptide level in hypertensive transgenic mice. Exp Anim 2004;53:11-9.
  • Ohba H, Takada H, Musha H, Nagashima J, Mori N, Awaya T, et al. Effects of prolonged strenuous exercise on plasma levels of atrial natriuretic peptide and brain natriuretic peptide in healthy men. Am Heart J 2001;141:751-8.
  • Potter LR, Abbey-Rosch S, Dickey DM. Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions. Endocr Rev 2006;27:47-72.
  • Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res 2003;17:822-31.
  • Rowland T, Unnithan V. Myocardial inotropic response to progressive exercise in healthy subjects: a review. Curr Sports Med Rep 2013;12:93-100.
  • Shewchuk LD, Baracos VE, Field CJ. Dietary L-glutamine supplementation reduces the growth of the Morris hepatoma in exercise-trained and sedentary rats. J Nutr 1997;127:158-66.
  • Tanaka H, Shindo M, Gutkowska J, Kinoshita A, Urata H, Ikeda M, et al. Effect of acute exercise on plasma immunoreactive atrial natriuretic factor. Life Sci 1986;39:1685-93.
  • Volek JS, Rawson ES. Scientific basis and practical aspects of creatine supplementation for athletes. Eur J Clin Nutr 2002;56:585-92.
  • Waddell D, Fredricks K. Effects of glutamine supplement on the skeletal muscle contractile force of mice. Am J Undergr Res 2005;4:11-8.
  • Walsh NP, Blannin AK, Clark AM, Cook L, Robson PJ, Gleeson M, et al. The effects of high-intensity intermittent exercise on the plasma concentrations of glutamine and organic acids. Eur J Appl Physiol 1998;77:434-8.
  • Wax B, Kavazis AN, Webb HE, Brown SP. Acute L-arginine alpha ketoglutarate supplementation fails to improve muscular performancein resistance trained and untrained men. J Int Soc Sports Nutr 2012;9:1-6.
  • Wiesner S, Birkenfeld AL, Engeli S, Haufe S, Brechtel L, Wein J, et al. Neurohumoral and metabolic response to exercise in water. Horm Metab Res 2010;42:334-9.
  • Williams AG, Ismail AN, Sharma A, Jones DA. Effects of resistance exercise volume and nutritional supplementation on anabolic and catabolic hormones. Eur J Appl Physiol 2002;86:315-21.

Publication Dates

  • Publication in this collection
    Jan-Mar 2015

History

  • Received
    07 Mar 2013
  • Accepted
    27 Jan 2015
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