Effect of Inorganic Nitrates (Beetroot Juice) on Arterial Hemodynamics and Exercise Capacity

Exclusion Criteria

• •1. Rhythm other than sinus rhythm (i.e., atrial fibrillation).
• •2. Neuromuscular, orthopedic or other non-cardiac condition that prevents patient from exercising.
• •3. Valve disease (\> mild aortic or mitral stenosis; \> moderate aortic or mitral regurgitation).
• •4. Hypertrophic cardiomyopathy.
• •5. Known infiltrative or inflammatory myocardial disease (amyloid, sarcoid).
• •6. Pericardial disease.
• •7. Primary pulmonary arteriopathy.
• •8. Have experienced a myocardial infarction or unstable angina, or have undergone percutaneous transluminal coronary angiography (PTCA) or coronary artery bypass grafting (CABG) within 60 days prior to consent, or requires either PTCA or CABG at the time of consent.
• •9. Other clinically important causes of dyspnea such as morbid obesity or significant lung disease defined by clinical judgment or use of steroids or oxygen for lung disease within the past 6 months.
• •10. Systolic blood pressure \< 110 mmHg or \> 180 mm Hg.
• •11. Diastolic blood pressure \< 40 mmHg or \> 100 mmHg.
• •12. Resting heart rate (HR) \> 100 bpm.
• •13. Hemoglobin \<10 g/dL.
• •14. Patients with known severe liver disease (AST \> 3x normal, alkaline phosphatase or bilirubin \> 2x normal).
• •15. Patients with a clinically indicated stress test demonstrating significant ischemia within a year of enrollment which was not followed by percutaneous or surgical revascularization.
• •16. Current therapy with phosphodiesterase inhibitors, such as sildenafil, vardanafil or tadalafil.
• •17. Known allergies to beetroot or lemon juice.
• •18. Current use of organic nitrates or phosphodiesterase inhibitors.
• •19. Pregnancy. Although beetroot juice has not knows teratogenic effects, we feel that not enough data exist in this regard. Therefore, all females patients of reproductive age will be required to undergo a pregnancy test prior to enrollment.