| Changes in the peripheral circulation in heart failure. | |
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MedLine Citation:
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PMID: 7612976 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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H Drexler |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Current opinion in cardiology Volume: 10 ISSN: 0268-4705 ISO Abbreviation: Curr. Opin. Cardiol. Publication Date: 1995 May |
Date Detail:
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Created Date: 1995-08-18 Completed Date: 1995-08-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8608087 Medline TA: Curr Opin Cardiol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 268-73 Citation Subset: IM |
Affiliation:
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Med. Klinik III, University of Freiburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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