Document Detail

31P nuclear magnetic resonance evidence of abnormal skeletal muscle metabolism in patients with congestive heart failure.
MedLine Citation:
PMID:  3618489     Owner:  NLM     Status:  MEDLINE    
In patients with congestive heart failure (CHF), exercise limitation correlates poorly with central hemodynamic abnormalities, suggesting that additional abnormalities in skeletal muscle blood flow or metabolism play an important pathophysiologic role. Therefore, muscle metabolism was examined by 31P nuclear magnetic resonance (NMR) at rest and during repetitive bulb squeeze exercise in 11 patients with New York Heart Association class II to IV CHF and 7 age-matched control subjects. Serial spectra were obtained at rest, at 2 levels of exercise and during recovery. At rest, the only abnormal finding was an elevated inorganic phosphate (Pi) concentration (5.0 +/- 1.5 vs 3.6 +/- 0.4 mM, p less than 0.01). At the lower exercise level, phosphocreatine (PCr) utilization, which was followed as the ratio of [PCr]/[( PCr] + [Pi]), was greater (0.36 +/- 0.16 vs 0.53 +/- 0.10, p less than 0.02), and pH fell more rapidly and to a lower value (6.38 +/- 0.25 vs 6.85 +/- 0.17, p less than 0.001). At the higher level of exercise, the patients could not work effectively and the group differences narrowed. Compared with control subjects, acidification was disproportionately greater in relation to PCr depletion in patients, further suggesting excessive dependence on glycolytic metabolism. The Pi peak was prominently double in 5 patients, indicating presence of a population of muscle fibers undergoing unusually active glycolysis. PCr resynthesis, a reflection of oxidative phosphorylation, was delayed in 4 patients. These findings indicate that in many patients with CHF, exercising muscle has marked metabolic changes consistent with impaired substrate availability and altered biochemistry.
B M Massie; M Conway; R Yonge; S Frostick; P Sleight; J Ledingham; G Radda; B Rajagopalan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  60     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1987 Aug 
Date Detail:
Created Date:  1987-09-08     Completed Date:  1987-09-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  309-15     Citation Subset:  AIM; IM; S    
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MeSH Terms
Adenosine Triphosphate / metabolism
Heart Failure / diagnosis*,  metabolism
Magnetic Resonance Spectroscopy / diagnostic use*
Middle Aged
Muscles / metabolism*,  pathology
Phosphates / metabolism
Phosphocreatine / metabolism
Phosphorus Isotopes
Physical Exertion
Grant Support
Reg. No./Substance:
0/Phosphates; 0/Phosphorus Isotopes; 56-65-5/Adenosine Triphosphate; 67-07-2/Phosphocreatine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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