Chronic heart failure and exercise

Muscle wastage in heart failure: Orphan of the heart failure

“…A number of biochemical abnormalities in skeletal muscle have been identified in patients with HF [20]. In one study, for example, skeletal muscle biopsy revealed atrophy of both type IIa and IIb fibers, an increased percentage of the fast twitch, easily fatigable type IIb fibers, and preservation of type I fiber size [26].…”

“…The inability of an acute increase in cardiac output to improve exercise tolerance in patients with HF suggests that factors in addition to the low muscle blood flow during exercise may be involved [20,21]. One such factor is skeletal muscle dysfunction induced by chronic hypoperfusion which can lead to muscle wasting, interference with oxygen utilization, and delayed recovery of muscle and total body oxygenation after submaximal exercise [21].…”

“…A number of functional abnormalities have been identified in patients with HF in addition to these structural and biochemical defects, [20]. Skeletal muscle ergoreceptors or metaboreceptors are enhanced in HF, possibly resulting in an increase in the ventilatory response to exercise and the sensation of dyspnea [21].…”

“…It has been demonstrated that significant skeletal muscular pathology is present in HF and may contribute to the associated symptoms [20]. The inability of an acute increase in cardiac output to improve exercise tolerance in patients with HF suggests that factors in addition to the low muscle blood flow during exercise may be involved [20,21].…”

Improved Exercise Capacity After Cardiac Rehabilitation Is Associated with Reduced Visceral Fat in Patients with Chronic Heart Failure

“…1) This reduced exercise capacity leads to a reduction in skeletal muscle mass and function. Muscle wasting has been shown to have prognostic importance in patients with CHF; 2) therefore, maintaining muscle mass and function is an important part of CHF treatment.…”