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Unraveling new mechanisms of exercise intolerance in chronic heart failure. Role of exercise training.
MedLine Citation:
PMID:  22684340     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Despite remarkable progress in the therapeutic approach of patients with chronic heart failure (CHF), exercise intolerance remains one of the hallmarks of the disease. During the past two decades, evidence has accumulated to underscore the key role of both endothelial dysfunction and skeletal muscle wasting in the process that gradually leads to physical incapacity. Whereas reverse ventricular remodeling has been attributed to aerobic exercise training, the vast majority of studies conducted in this specific patient population emphasize the reversal of peripheral abnormalities. In this review, we provide a general overview on underlying pathophysiological mechanisms. In addition, emphasis is put on recently identified pathways, which contribute to a deeper understanding of the main causes of exercise tolerance and the potential for reversal through exercise training. Recently, deficient bone marrow-related endothelial repair mechanisms have received considerable attention. Both acute exercise bouts, as well as exercise training, affect the mobilization of endothelial progenitor cells and their function. The observed changes following exercise training are believed to significantly contribute to improvement of peripheral endothelial function, as well as exercise capacity. With regard to skeletal muscle dysfunction and energy deprivation, adiponectin has been suggested to play a significant role. The demonstration of local skeletal muscle adiponectin resistance may provide an interesting and new link between the insulin resistant state and skeletal muscle wasting in CHF patients.
Authors:
Viviane M Conraads; Emeline M Van Craenenbroeck; Catherine De Maeyer; An M Van Berendoncks; Paul J Beckers; Christiaan J Vrints
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-10
Journal Detail:
Title:  Heart failure reviews     Volume:  -     ISSN:  1573-7322     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612481     Medline TA:  Heart Fail Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium, Viviane.Conraads@uza.be.
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