| Exercise limitation in chronic heart failure: central role of the periphery. | |
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MedLine Citation:
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PMID: 8890800 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The symptoms of chronic heart failure (CHF) are predominantly shortness of breath and fatigue during exercise and reduced exercise capacity. Disturbances of central hemodynamic function are no longer considered to be the major determinants of exercise capacity. The two symptoms of fatigue and breathlessness are often considered in isolation. A pulmonary abnormality is usually considered to be the cause of abnormal ventilation, and increased dead space ventilation has come to be accepted as a major cause of the increased ventilation relative to carbon dioxide production seen in CHF. Rather than decreased skeletal muscle perfusion, an intrinsic muscle abnormality is considered to be responsible for fatigue. Another abnormality seen in CHF is persistent sympathetic nervous system activation, which is difficult to explain on the basis of baroreflex activation. There is increasing evidence for the importance of skeletal muscle ergoreceptors or metaboreceptors in CHF. These receptors are sensitive to work performed, and activation results in increased ventilation and sympathetic activation. The ergoreflex appears to be greatly enhanced in CHF. We put forward the "muscle hypothesis" as an explanation for many of the pathophysiologic events in CHF. Impaired skeletal muscle function results in ergoreflex activation. In turn, this causes increased ventilation, thus linking the symptoms of breathlessness and fatigue. Furthermore, ergoreflex stimulation may be responsible for persistent sympathetic activation. |
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Authors:
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A L Clark; P A Poole-Wilson; A J Coats |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 28 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1996 Nov |
Date Detail:
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Created Date: 1996-12-09 Completed Date: 1996-12-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1092-102 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Medicine, National Heart and Lung Institute, London, England, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Exercise* Exercise Therapy Fatigue / etiology Heart Failure / complications, physiopathology*, therapy Hemodynamics Humans Lung / physiopathology Muscle, Skeletal / blood supply, physiopathology Respiration |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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