Document Detail


Effect of exercise training on skeletal muscle fibre characteristics in men with chronic heart failure. Correlation between skeletal muscle alterations, cytokines and exercise capacity.
MedLine Citation:
PMID:  11959380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with congestive heart failure (CHF) there is a shift from aerobic type I muscle fibres to less aerobic type II fibres. Exercise training has been shown to have beneficial effects on exercise performance, peripheral pathology and the neurohumoral profile in stable patients with CHF. This study evaluated the effect of a 3 month exercise training program on skeletal muscle characteristics and the correlation of these to cytokines and exercise capacity in CHF patients. METHODS: Skeletal muscle biopsies for enzyme-histochemical analysis were performed in 15 CHF patients in New York Heart Association classes II-III, with a mean ejection fraction of 33+/-5% before and after a 12 week training period. The patients were trained for 30 min, five times a week at 80% of the peak heart rate achieved at baseline ergometer cycle test. Fifteen healthy men were used as controls. Plasma samples were examined by enzyme immunoassays for levels of pro-inflammatory cytokines. RESULTS: (a) At baseline we found muscle atrophy in five of the patients. The percent area of type I fibres (40.7+/-12.0 vs. 56.4+/-11.0%, P<0.05) and the thickness of type IIA (56.10+/-7.8 vs. 71.6+/-11.9 microm, P<0.001) and B-fibres (49.0+/-8.9 vs. 63.9+/-10.6 microm, P<0.001) were reduced, whereas the percent area of type IIA fibres (52.1+/-13.3 vs. 36.4+/-9.9%, P<0.05) was increased in heart failure patients compared to healthy controls. There was a modest correlation between fibre thickness and the level of interleukin 6 (r=-0.657, P=0.008). (b) After exercise training there was a reduction in muscle area examined by light-microscopy, measured as a percentage of field (-2.7, P=0.003) with an concomitant increase in interstitium. This reduction correlated to the increase in the 6-min walk test (r=-0.558, P=0.031). The thickness of type IIB fibres increased (+5.6 microm, P=0.068) and the area of type I fibres decreased (-6.1%, P=0.062). CONCLUSIONS: Patients with CHF have a relatively increased area of type IIA fibres and a relatively decreased area of type I fibres compared to healthy individuals. The thickness of type IIA and type IIB fibres is decreased compared to normal individuals. A modest negative correlation between the level of interleukin 6 and fibre thickness at baseline, suggests that inflammatory cytokines may be involved in the pathogenesis of the CHF related myopathy. A significant correlation between the reduction of muscle area, with increased interstitum, and the increase in the 6-min walk test may indicate that the improvement is due to increased capillary density permitting better flow reserve to exercising muscles.
Authors:
Alf Inge Larsen; Sigurd Lindal; Pål Aukrust; Ingrid Toft; Torbjørn Aarsland; Kenneth Dickstein
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  83     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-17     Completed Date:  2002-06-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  25-32     Citation Subset:  IM    
Affiliation:
Cardiology Division, Central Hospital in Rogaland, P.O. Box 8100, N4001 Stavanger, Norway. al-i-lar@online.no
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MeSH Terms
Descriptor/Qualifier:
Aged
Biopsy
Chronic Disease
Cytokines / blood*
Exercise Therapy*
Exercise Tolerance / physiology
Follow-Up Studies
Heart Failure / blood*,  physiopathology*
Humans
Interleukin-6 / blood
Interleukin-8 / blood
Male
Middle Aged
Muscle, Skeletal / metabolism*,  pathology
Oxygen Consumption / physiology
Statistics as Topic
Stroke Volume / physiology
Treatment Outcome
Tumor Necrosis Factor-alpha / metabolism
Walking
Chemical
Reg. No./Substance:
0/Cytokines; 0/Interleukin-6; 0/Interleukin-8; 0/Tumor Necrosis Factor-alpha
Comments/Corrections
Comment In:
Int J Cardiol. 2002 Apr;83(1):33-4   [PMID:  11959381 ]

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


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