“…Intrinsic skeletal muscle abnormalities have been described in heart failure patients and hypothesized to play a role in exercise intolerance [1,2,3,4,5,6,7]. Skeletal muscle alterations such as atrophy, fibrosis, decreased oxidative capacity, altered myosin distribution, and contractile dysfunction have been well characterized in several experimental and clinical heart failure studies [3,6,7,8,9,10,11]. However, the causal or contributing factors responsible for muscle alterations have not been completely defined.…”