Relation of systemic and local muscle exercise capacity to skeletal muscle characteristics in men with congestive heart failure

Massie, Barry M.; Simonini, Americo; Sahgal, Puneet; Wells, Lauren; Dudley, Gary A.

doi:10.1016/0735-1097(95)00416-5

Cited by 122 publications

(103 citation statements)

References 34 publications

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“…Alterations in skeletal muscle morphology and function, including atrophy, 2,4 changes in fiber type composition, 2,3,25,26 decreased oxidative capacity, 2,25,27,28 abnormal high-energy phosphate handling, 29 and exercise-induced hyperkalemia, 30 have been demonstrated in heart failure. Given these changes, it has been hypothesized that neural reflexes originating within skeletal muscle (ie, the EPR) potentially contribute to the aberrant cardiovascular response to physical activity noted with the pathogenesis of CHF.…”

Section: Discussionmentioning

confidence: 99%

“…23 If this scenario proves valid, there may be periods of hyperexcitability for both metabolically and mechanically sensitive afferents during the course of heart failure that explain some of the discrepancies reported in previous human studies. 10,14,21,22 In addition, other factors, including modifications in muscle metabolism and fiber type composition (eg, reductions in the percentage of oxidative fibers and increases in the percentage of glycolytic fibers), 2,3,25 may facilitate these disease-induced alterations in reflex function. For example, because the EPR-mediated circulatory response to activation of glycolytic muscle has been shown to be greater than the response elicited from oxidative muscle, 36 fiber-type transformations could profoundly effect the physiological expression of the pressor reflex.…”

Section: Perspectivesmentioning

confidence: 99%

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Role of the Exercise Pressor Reflex in Rats With Dilated Cardiomyopathy

et al. 2003

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Background-In heart failure, there is a sympathetically mediated hyperkinetic cardiovascular response to exercise that limits tolerance to physical activity. Alterations in skeletal muscle morphology and metabolism have led to the hypothesis that the exercise pressor reflex (EPR) becomes hyperactive after the development of cardiomyopathy and contributes to the exaggerated circulatory response elicited. Methods and Results-To test this hypothesis, Sprague-Dawley rats were divided into the following groups: control, sham, and dilated cardiomyopathy (DCM, induced by ischemic injury). Using transthoracic echocardiography, left ventricular fractional shortening was 47Ϯ2%, 44Ϯ1%, and 24Ϯ2% in control, sham, and DCM rats, respectively. Activation of the EPR by electrically induced static muscle contraction resulted in significantly larger increases in mean arterial pressure and heart rate in DCM animals (32Ϯ2 mm Hg, 13Ϯ1 bpm) compared with control (20Ϯ1 mm Hg, 8Ϯ1 bpm) and sham (20Ϯ2 mm Hg, 8Ϯ1 bpm) rats. Comparable results were obtained with selective stimulation of the mechanically sensitive component of the EPR by passive muscle stretch. The augmentations in EPR and mechanoreflex activity in DCM occurred progressively over a 10-week period, becoming greater as the severity of left ventricular dysfunction increased. Conclusions-In DCM, the potentiated cardiovascular response to static muscle contraction is mediated, in part, by an exaggerated EPR. The muscle mechanoreflex contributes significantly to the EPR dysfunction that develops.

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Section: Discussionmentioning

confidence: 99%

Section: Perspectivesmentioning

confidence: 99%

Role of the Exercise Pressor Reflex in Rats With Dilated Cardiomyopathy

et al. 2003

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“…Significant muscle fiber atrophy 33 and reduced total muscle cross sectional areas 27 have also been reported in CHF patients. Alterations in fiber type…”

Section: Muscle Fiber Types Muscle Biopsy Studies In Chf Have Consismentioning

confidence: 99%

Reduced exercise tolerance in CHF may be related to factors other than impaired skeletal muscle oxidative capacity

Williams¹,

Selig²,

Hare³

et al. 2004

Journal of Cardiac Failure

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“…27 Muito tempo se passou e em 1993 chegou-se à conclusão que a diminuição na produção de força máxima dos pacientes com insuficiência cardíaca persiste mesmo quando as forças são normalizadas pela massa muscular úmida e/ou pela área de secção transversa do músculo. 28 Além disso, as anormalidades supracitadas, como atrofia, mudança do tipo de fibra e menor prevalência do metabolismo aeróbio, não são prováveis de explicar completamente o padrão de fadiga muscular dos pacientes, que devido à sua velocidade e gravidade parece refletir prejuízo no acoplamento excitação-contração 16,[29][30][31] , que está diretamente relacionado ao íon Ca 2+ .…”

Section: Alterações Molecularesunclassified

Relevância e tratamento das lesões características da insuficiência cardíaca na musculatura esquelética

Júnior

2009

Medicina (Ribeirão Preto)

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Pacientes com insuficiência cardíaca, a via final das doenças cardiovasculares e a primeira causa de internação em idosos no Brasil, apresentam deterioração do tecido muscular esquelético. Além disso, as lesões na musculatura têm relação direta com a qualidade de vida e a autonomia dos pacientes, por meio do nível de tolerância aos esforços físicos, além de constituírem um preditor independente de mortalidade na síndrome. Ao longo da presente revisão de literatura serão discutidos em relação à insuficiência cardíaca: seu conceito e um breve histórico; a importância da musculatura esquelética; as anormalidades funcionais, estruturais, bioquímicos e moleculares que acometem esse tecido; as potenciais causas dessas alterações (hiperatividade simpática, redução na ingestão alimentar, espécies reativas de oxigênio, citocinas pró-inflamatórias e diminuição do nível de atividade física e do fluxo sanguíneo); e os efeitos da principal terapia direcionada para combater essa disfunção, o treinamento físico aeróbio de intensidade moderada. Reconhecida a importância do tecido muscular esquelético na síndrome, essa é uma área da investigação científica com muitos temas ainda não estudados, como o efeito de terapias farmacológicas utilizadas pelos pacientes, de exercícios físicos aeróbios de maior intensidade e intervalados, de exercícios físicos de força, de intervenções nutricionais e de terapias celulares e gênicas. No futuro, os resultados desses estudos que serão desenvolvidos certamente contribuirão para uma menor degeneração da musculatura esquelética na doença, o que, consequentemente, vai melhorar a ualidade de vida, a autonomia e o prognóstico dos pacientes.

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Relation of systemic and local muscle exercise capacity to skeletal muscle characteristics in men with congestive heart failure

Cited by 122 publications

References 34 publications

Role of the Exercise Pressor Reflex in Rats With Dilated Cardiomyopathy

Role of the Exercise Pressor Reflex in Rats With Dilated Cardiomyopathy

Reduced exercise tolerance in CHF may be related to factors other than impaired skeletal muscle oxidative capacity

Relevância e tratamento das lesões características da insuficiência cardíaca na musculatura esquelética

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