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December 27, 2001; revised July 4, 2002; accepted August 12, 2002 Chronic heart failure (HF) is a common and debilitating condition with high rates of mortality and morbidity. The prevalence of symptomatic HF in the general European population ranges from 0.4%-2% and is expected to increase as the population ages.1 Commonly, symptom generation in chronic HF was attributed to central hemodynamic alterations, but other factors, such as skeletal muscle changes, may also play a role. The purpose of the present review is to summarize the available data on the widespread abnormalities which skeletal muscle develops in the course of chronic HF, and to discuss how such alterations may be generated and their role in the onset of the typical symptoms of this condition.

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