Document Detail


Changes in the peripheral circulation in heart failure.
MedLine Citation:
PMID:  7612976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic heart failure is associated with neurohumoral activation and alterations of the peripheral circulation and skeletal muscle. Several mechanisms are involved in the impaired peripheral perfusion, including increased sympathetic tone and increased vascular stiffness. Recently, data have suggested an important role of the endothelium for perfusion of skeletal muscle in heart failure. Endothelium-dependent dilation of resistance vessels is blunted in patients with severe chronic heart failure. Conceivably, this abnormality may be involved in the impaired reactive hyperemia seen in patients with chronic heart failure. In conductance vessels, flow-dependent dilation is attenuated in patients with chronic heart failure as compared with normal subjects, indicating endothelial dysfunction of large conduit vessels. Dysfunctional endothelium may contribute to impaired tissue perfusion in heart failure. Beyond an impairment of perfusion, skeletal muscle itself is altered in chronic heart failure. The metabolic abnormalities of skeletal muscle in patients with heart failure do not result from inadequate O2 delivery, but from inadequate O2 utilization by mitochondria, consistent with previous findings that the oxidative capacity of mitochondria in skeletal muscle is reduced. It appears that the impaired muscular endurance in heart failure is related to an enhanced glycolytic metabolism secondary to the reduced oxidative capacity of skeletal muscle. The observed low muscular strength appears to be due to a smaller muscle cross-sectional area. Despite successful heart transplantation, only partial improvement of bioenergetic abnormalities was noted in patients 15 months after heart transplantation.
Authors:
H Drexler
Related Documents :
7170436 - The origin of concepts regarding contractility, its mechanism, and its control.
3986306 - Isoproterenol induces a ribosomal modification in the heart and the skeletal muscle of ...
7594206 - Mechanism of the decline in vagal cardiac acceleration in dogs in neuroleptanaesthesia.
7702166 - Facial sensory evoked muscle potentials during labour. a continuous objective monitor o...
978216 - Microdissection of peripheral nerve: collagen and lipid distribution with morphological...
9575366 - Perineal muscles and their innervation: metabolic and functional significance of the mo...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  10     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-08-18     Completed Date:  1995-08-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  268-73     Citation Subset:  IM    
Affiliation:
Med. Klinik III, University of Freiburg, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Blood Circulation*
Chronic Disease
Endothelium, Vascular / physiopathology
Heart Failure / physiopathology*
Humans
Muscles / metabolism
Oxygen Consumption

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


Previous Document:  Characteristics and clinical relevance of animal models of heart failure.
Next Document:  Mechanisms and management of arrhythmias in heart failure.