Skeletal muscle metabolism limits exercise capacity in patients with chronic heart failure

Several studies have indicated that skeletal muscle is important in determining the exercise capacity of patients with chronic heart failure (CHF). However, this theory has been investigated only in experiments based on local exercise involving a small muscle mass. We investigated skeletal muscle me...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-11, Vol.98 (18), p.1886-1891
Main Authors: OKITA, K, YONEZAWA, K, NISHIJIMA, H, HANADA, A, OHTSUBO, M, KOHYA, T, MURAKAMI, T, KITABATAKE, A
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiac Output, Low - diagnosis
Cardiac Output, Low - metabolism
Cardiac Output, Low - physiopathology
Cardiology. Vascular system
Chronic Disease
Exercise
Heart
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Magnetic Resonance Spectroscopy
Male
Medical sciences
Middle Aged
Muscle, Skeletal - metabolism
Phosphocreatine - metabolism
Physical Endurance
Reference Values
Space life sciences
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Summary:Several studies have indicated that skeletal muscle is important in determining the exercise capacity of patients with chronic heart failure (CHF). However, this theory has been investigated only in experiments based on local exercise involving a small muscle mass. We investigated skeletal muscle metabolism during maximal systemic exercise to determine whether muscle metabolism limits exercise capacity in patients with CHF. We also studied the relationship between muscle metabolic abnormalities during local and systemic exercise. Skeletal muscle metabolism was measured during maximal systemic exercise on a bicycle ergometer by a combination of the metabolic freeze method and 31P magnetic resonance spectroscopy in 12 patients with CHF and 7 age- and size-matched normal subjects. We also evaluated skeletal muscle metabolism during local exercise while subjects performed unilateral plantar flexion. Muscle phosphocreatine (PCr) was nearly depleted during maximal systemic exercise in patients with CHF and normal subjects (12.5+/-0.04% and 12.3+/-0.07%, respectively, of initial level). PCr depletion occurred at a significantly lower peak oxygen uptake (peak VO2) in patients with CHF than in normal subjects (CHF, 20.2+/-3.0 versus normal, 31.8+/-3.7 mL . min-1 . kg-1, P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.98.18.1886