The Influence of a 12-Week Exercise Program on Asymmetric Dimethylarginine and Uric Acid Levels in Adults with Congenital Heart Disease–Associated Pulmonary Hypertension

Abstract

Exercise-based rehabilitation may improve functional outcomes in pulmonary hypertension, but its effects on endothelial and metabolic biomarkers in adults with congenital heart disease-associated pulmonary hypertension remain uncertain. This study evaluated the influence of a 12-week exercise program on asymmetric dimethylarginine and uric acid levels. This single-arm pre-post interventional study included 13 adults with congenital heart disease-associated pulmonary hypertension. Participants completed supervised moderate-intensity aerobic exercise twice weekly for 12 weeks, at 40%–60% of heart rate reserve for 30 minutes per session, with daily incentive spirometry. Asymmetric dimethylarginine and uric acid levels were measured at baseline and week 12 and compared using paired-samples t tests. Participants had a mean age of 32.92 ± 8.22 years, and 76.9% were female. Mean asymmetric dimethylarginine decreased from 20,933.27 ng/L at baseline to 18,518.38 ng/L at week 12; this difference was not statistically significant (t = 0.610, p = 0.553). Mean uric acid increased from 7.76 to 8.27 mg/dL, also without a statistically significant difference (t = -2.027, p = 0.066). A 12-week supervised exercise program was not associated with statistically significant changes in asymmetric dimethylarginine or uric acid levels in adults with congenital heart disease-associated pulmonary hypertension. The differing directional responses suggest that endothelial and metabolic adaptations to exercise may vary within this population.