Acute Effects of Beet Juice Consumption on Exercise Capacity in Heart Failure

Participants will complete up to four study visits. The first visit will involve completion
of the informed consent process followed by a screening for study eligibility. The screening
will consist of questionnaires pertaining to detailed medical history, diet, physical
activity, and health-related quality of life (KCCQ). Anthropometric measures and a general
health screening (including heart rate, resting blood pressure, and small blood (<15 mL) and
urine samples will be collected). Volunteers meeting eligibility requirements will be
scheduled for a screening maximal cardiopulmonary exercise test. Immediately prior to the
exercise treadmill test, each subject will have a resting ECG and blood pressure to
determine whether there are any abnormalities that would contraindicate exercise testing.
Qualified subjects will then undergo a maximal cardiopulmonary exercise (CPX) test.

Following successful completion of the screening CPX test, volunteers meeting eligibility
requirements will be scheduled for two testing visits, at least one week apart. At one
visit, participants will consume a small cup of beet juice concentrate, and at the other,
they will consume placebo. Treatment will be double-blinded and administered in random
order.

Inclusion Criteria:

- New York Heart Association (NYHA) class II-III heart failure

- receiving optimal medical therapy

- sedentary

Exclusion Criteria:

- smoking

- changes in medication or major cardiovascular (CV) event or procedure within the
previous 6 wk

- fixed rate pacemaker

- unstable angina

- other co-morbidities or limitations that preclude safe participation in the exercise
testing

- plans for hospitalization or cardiac transplantation within the next 2 months

- type 1 diabetes

- refusal or inability to provide informed consent