Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2014, Article ID 341603, 8 pages
Review Article

Essential Amino Acids and Exercise Tolerance in Elderly Muscle-Depleted Subjects with Chronic Diseases: A Rehabilitation without Rehabilitation?

1Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica, Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Montescano, Via per Montescano 31, Montescano, 27040 Pavia, Italy
2Laboratorio Universitario per lo Studio delle Attività Motorie nelle Malattie Rare (LUSAMMR), Via Ugo Foscolo 13, Voghera, 27058 Pavia, Italy
3Dipartimento di Medicina Molecolare, Università degli Studi di Pavia, Viale Taramelli 3/B, 27100 Pavia, Italy
4Direzione Scientifica Centrale, Fondazione Salvatore Maugeri, IRCCS, Via Salvatore Maugeri 8-10, 27100 Pavia, Italy
5Consorzio Valutazioni Biologiche e Farmacologiche, Via Luigi Porta 14, 27100 Pavia, Italy
6Dipartimento di Biologia e Biotecnologie, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy
7Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Lumezzane, Via Mazzini 9, Lumezzane, 25065 Brescia, Italy
8Dipartimento di Medicina Legale, Scienze Forensi e Farmaco-Tossicologiche “A. Fornari”, Sezione di Scienze Farmacologiche e Tossicologiche, Università degli Studi di Pavia, 27100 Pavia, Italy
9Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Viale Taramelli 14, 27100 Pavia, Italy

Received 11 February 2014; Accepted 20 May 2014; Published 9 June 2014

Academic Editor: Enzo Nisoli

Copyright © 2014 Roberto Aquilani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Exercise intolerance remains problematic in subjects with chronic heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD). Recent studies show that supplemented essential amino acids (EAAs) may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects) served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d). In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test), and 12% to 22% (meters) in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25%) and improved tissue insulin sensitivity by 16% (HOMA index). COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population). These mechanisms could be accounted for by EAA’s intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.