Implications of chronic heart failure on peripheral vasculature and skeletal muscle before and after exercise training

 The pathophysiology of chronic heart failure (CHF) is typically conceptualized in terms of cardiac dysfunction. However, alterations in peripheral blood flow and intrinsic skeletal muscle properties are also now recognized as mechanisms for exercise intolerance that can be modified by therapeutic e...

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Bibliographic Details
Published in:Heart failure reviews 2008-02, Vol.13 (1), p.21-37
Main Authors: Duscha, Brian D., Schulze, P. Christian, Robbins, Jennifer L., Forman, Daniel E.
Format: Article
Language:English
Subjects:
Animals
Apoptosis
Cardiology
Chronic Disease
Exercise - physiology
Exercise Therapy
Exercise Tolerance
Heart Failure - physiopathology
Heart Failure - rehabilitation
Hemodynamics
Humans
Inflammation
Insulin-Like Growth Factor I - metabolism
Leg - blood supply
Leg - physiology
Medicine
Medicine & Public Health
Muscle, Skeletal - blood supply
Muscle, Skeletal - physiology
Oxygen Consumption
Regional Blood Flow - physiology
Signal Transduction
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Summary: The pathophysiology of chronic heart failure (CHF) is typically conceptualized in terms of cardiac dysfunction. However, alterations in peripheral blood flow and intrinsic skeletal muscle properties are also now recognized as mechanisms for exercise intolerance that can be modified by therapeutic exercise. This overview focuses on blood delivery, oxygen extraction and utilization that result from heart failure. Related features of inflammation, changes in skeletal muscle signaling pathways, and vulnerability to skeletal muscle atrophy are discussed. Specific focus is given to the ways in which perfusion and skeletal muscle properties affect exercise intolerance and how peripheral improvements following exercise training increase aerobic capacity. We also identify gaps in the literature that may constitute priorities for further investigation.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-007-9056-8