Significance of cardiac weight in patients having coronary artery bypass grafting for angina pectoris

Kalan, Jay M.; Roberts, William C.

doi:10.1016/0002-9149(88)91361-6

Cited by 9 publications

(1 citation statement)

References 13 publications

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“…Patients with HFrEF often have multiple physiologic system dysfunction leading to excessive sympathetic nerve activity, reduced limb blood flow, muscle deconditioning, and a number of pulmonary complications including pulmonary hypertension, impaired gas exchange and altered ventilatory control [1–4]. Thus, these changes in the periphery, in contrast to left ventricular performance itself, may be the primary mediators limiting exercise capacity in these patients [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure

Keller‐Ross

Johnson

Carter³

et al. 2016

International Journal of Cardiology

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Background Skeletal muscle atrophy contributes to increased afferent feedback (group III and IV) and may influence ventilatory control (high VE/VCO2 slope) in heart failure (HF). Objective This study examined the influence of muscle mass on the change in VE/VCO2 with afferent neural block during exercise in HF. Methods 17 participants [9 HF (60±6 yrs) and 8 controls (CTL) (63±7 yrs, mean±SD)] completed 3 sessions. Session 1: dual energy x-ray absorptiometry and graded cycle exercise to volitional fatigue. Sessions 2 and 3: 5 min of constant-work cycle exercise (65% of peak power) randomized to lumbar intrathecal injection of fentanyl (afferent blockade) or placebo. Ventilation (VE) and gas exchange (oxygen consumption, VO2; carbon dioxide production, VCO2) were measured. Results Peak work and VO2 were lower in HF (p<0.05). Leg fat was greater in HF (34.4±3.0 and 26.3±1.8%) and leg muscle mass was lower in HF (63.0±2.8 and 70.4±1.8%, respectively, p<0.05). VE/VCO2 slope was reduced in HF during afferent blockade compared with CTL (−18.8±2.7 and −1.4±2.0%, respectively, p=0.02) and was positively associated with leg muscle mass (r2=0.58, p<0.01) and negatively associated with leg fat mass (r2=0.73, p<0.01) in HF only. Conclusions HF patients with the highest fat mass and the least leg muscle mass had the greatest improvement in VE/VCO2 with afferent blockade with leg fat mass being the only predictor for the improvement in VE/VCO2 slope. Both leg muscle mass and fat mass are important contributors to ventilatory abnormalities and strongly associated to improvements in VE/VCO2 slope with locomotor afferent inhibition in HF.

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