Document Detail


Exercise capacity in heart failure patients: relative importance of heart and skeletal muscle.
MedLine Citation:
PMID:  8964135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The knee extensor and the whole-body exercise capacities were measured in 11 chronic heart failure (CHF) patients and 11 healthy age- and sex-matched controls, and were related to ejection fraction and to biochemical and histochemical markers of the musculature. The CHF patients had a 39% lower maximal oxygen uptake measured on an ergometer cycle than the healthy controls (1.54 +/- 0.57 vs. 2.51 +/- 0.70 1 min-1, P < 0.001). The low exercise capacity was markedly related to the ejection fraction (r = 0.77, P < 0.001). The maximal strength of m. quadriceps femoris was 15% lower in the CHF patients than in the controls (P < 0.05). The cross-sectional area (CSA) of m. quadriceps femoris explained 55% (r = 0.74, P < 0.001) of the difference in strength between both groups. The endurance capacity of m. quadriceps femoris was 30% lower in CHF patients than in controls, partly as a result of the 25% lower capillary density (P < 0.05) and the 27% lower aerobic enzyme capacity (P < 0.05), as estimated by the citrate synthase activity, in the CHF patients. The citrate synthase activity correlated with the maximal oxygen uptake (r = 0.61, P < 0.05). Moreover, the ejection fraction, together with the CSA of m. quadriceps femoris, explained 75% (r = 0.86%, P < 0.01) of the difference in maximal oxygen uptake between CHF patients and controls. These results demonstrate that CHF patients have both a lower local and a lower whole-body work capacity than healthy controls. This is a function of a smaller leg muscle mass and a lower capillary density and mitochondrial enzyme capacity in the CHF patients; however, a lowered pump capacity of the heart is the factor which limits the exercise capacity the most.
Authors:
G Magnusson; L Kaijser; H Rong; B Isberg; C Sylvén; B Saltin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical physiology (Oxford, England)     Volume:  16     ISSN:  0144-5979     ISO Abbreviation:  Clin Physiol     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-12-10     Completed Date:  1996-12-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309768     Medline TA:  Clin Physiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  183-95     Citation Subset:  IM    
Affiliation:
Department of Physiology and Pharmacology, Karolinska Institute, Huddinge Hospital, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Aged
Capillaries / pathology
Enzymes / metabolism
Exercise Test
Female
Heart / physiopathology*
Heart Failure / pathology,  physiopathology*
Humans
Isometric Contraction
Leg
Male
Middle Aged
Muscle Fatigue
Muscle, Skeletal / blood supply,  pathology,  physiopathology*
Physical Endurance*
Chemical
Reg. No./Substance:
0/Enzymes

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


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