Skeletal Muscle Metabolism Limits Exercise Capacity in Patients With Chronic Heart Failure

Okita, Koichi; Yonezawa, Kazuya; Nishijima, Hirotaka; Hanada, Akiko; Ohtsubo, Mitsunori; Kohya, Tetsuro; Murakami, Takeshi; Kitabatake, Akira

doi:10.1161/01.cir.98.18.1886

Cited by 120 publications

(89 citation statements)

References 11 publications

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“…2,[24][25][26][27][28][29][30][31][32] Decreased muscular power as well as metabolic and endocrine disorders are also known as factors of exercise limitation. 9,[33][34][35][36][37] In 1968, Zelis, et al reported a decreased vasodilatory capacity in cardiac patients. 23) Since then, a number of investigations have been made on this matter.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Physical Training Improves Vasodilatory Capacity in Cardiac Patients.

et al. 2002

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SUMMARYThere have been no previous studies that clearly demonstrate the effects of training on the relation between exercise capacity and vasodilatory capacity in skeletal muscle. This study was performed to clarify the effects of short-term, moderate-intensity physical training on exercise tolerance and vasodilatory capacity in cardiac patients.We studied 21 patients after acute myocardial infarction, coronary artery bypass grafting, or valve replacement. Each patient performed symptom-limited incremental exercise tests before and after a 2-week training program of moderate-intensity exercise. A cycle ergometer was used for both the training and exercise tests. Blood pressure measurement and respiratory gas analysis were continuously performed during the tests. Cardiac output was also measured using a dye-dilution method at rest and every 2 minutes during incremental exercise. Reactive hyperemic calf blood flow was measured at rest.After the training program, the subjects attained a significant decrease in systemic vessel resistance and significant increases in oxygen uptake and cardiac output at peak exercise. Changes in reactive hyperemic calf blood flow were significantly correlated with the changes in cardiac output, systemic vascular resistance, and the kinetics of oxygen uptake during warm-up exercise.By improving the peripheral vasodilatory capacity in these patients, short-term, moderate-intensity physical training was found to improve the cardiovascular adaptation not only at peak exercise, but also during the onset of exercise. (Jpn Heart J 2002; 43: 13-24)

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Section: Discussionmentioning

confidence: 99%

Short-Term Physical Training Improves Vasodilatory Capacity in Cardiac Patients.

et al. 2002

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“…Additionally, the PCr concentration in muscle declines more rapidly during submaximal exercise in CHF patients indicating lower rates of oxidative phosphorylation for given absolute and relative submaximal exercise loads 6,42 . Skeletal muscle pH also began to decline earlier during exercise indicating an earlier onset of glycolysis.…”

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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“…The determinants of aerobic capacity are multifactorial, but aerobic capacity is generally believed to be impaired in the presence of abnormalities in skeletal muscle energy metabolism, 5 and energy metabolism largely depends on mitochondrial function. 6 Indeed, it has been shown that mitochondrial ATP production in skeletal muscle is impaired in insulin-resistant offspring of patients with type 2 diabetes, 7 which raises the possibility that mitochondrial oxidative phosphorylation in skeletal muscle might be impaired in MetS.…”

Section: Introductionmentioning

confidence: 99%

Lower aerobic capacity was associated with abnormal intramuscular energetics in patients with metabolic syndrome

et al. 2011

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Lower aerobic capacity is a strong and independent predictor of cardiovascular morbidity and mortality in patients with metabolic syndrome (MetS). However, the mechanisms are not fully elucidated. We tested the hypothesis that skeletal muscle dysfunction could contribute to the lower aerobic capacity in MetS patients. The incremental exercise tests with cycle ergometer were performed in 12 male patients with MetS with no habitual exercise and 11 age-, sex-and activity-matched control subjects to assess the aerobic capacity. We performed 31 phosphorus-magnetic resonance spectroscopy (MRS) to assess the high-energy phosphate metabolism in skeletal muscle during aerobic exercise. Proton-MRS was also performed to measure intramyocellular lipid (IMCL) content. Peak oxygen uptake (peak VO 2 ; 34.1±6.2 vs. 41.4±8.4 ml kg À1 min À1 , Po0.05) and anaerobic threshold (AT; 18.0±2.4 vs. 23.1±3.7 ml kg À1 min À1 , Po0.01) adjusted by lean body mass were lower in MetS patients than control subjects. Phosphocreatine (PCr) loss during exercise was 1.5-fold greater in MetS, suggesting reduced intramuscular oxidative capacity. PCr loss was inversely correlated with peak VO 2 (r¼À0.64) and AT (r¼À0.60), respectively. IMCL content was threefold higher in MetS and was inversely correlated with peak VO 2 (r¼À0.47) and AT (r¼À0.52), respectively. Moreover, there was a positive correlation between IMCL content and PCr loss (r¼0.64). These results suggested that lean-body aerobic capacity in MetS patients was lower compared with activity-matched healthy subjects, which might be due to the reduced intramuscular fatty acid oxidative metabolism.

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Skeletal Muscle Metabolism Limits Exercise Capacity in Patients With Chronic Heart Failure

Cited by 120 publications

References 11 publications

Short-Term Physical Training Improves Vasodilatory Capacity in Cardiac Patients.

Short-Term Physical Training Improves Vasodilatory Capacity in Cardiac Patients.

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

Lower aerobic capacity was associated with abnormal intramuscular energetics in patients with metabolic syndrome

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