Copyright © 1996 by the European Society of Cardiology.
© 1996 The European Society of Cardiology
Skeletal muscle changes in patients with chronic heart failure before and after treatment with enalapril
*Department of Medicine, Östra University Hospital Sweden
Department of Pediatrics, Östra University Hospital Sweden
Department of Rehabilitation Medicine, Sahlgrenska University Hospital Göteborg University Sweden
Received 15 January 1996; accepted 21 January 1996.
Correspondence: Maria Schaufelberger, Department of Medicine, Östra University Hospital, S-416 85 Göteborg. Sweden
Abstract
To evaluate if enalapril treatment can influence skeletal muscle metabolism and histology weinvestigated 26 patients with congestive heart failure and 20 normal subjects. The patients were treated with enalapril for 3 months in addition to diuretics and digitalis. Biopsies from thelateral vastus muscle were taken before and after treatment. Citrate synthetase, 3-hydroxyacyl-CoA dehydrogenase and phosphorylase activities were significantly decreased in the patients compared with controls. The number of capillaries per fibre and the number of capillaries surrounding each fibre were significantly decreased among patients. After 3 months of enalapril treatment functional class improved significantly. The lactate dehydrogenase activity increased whereas the oxidative enzymes did not change significantly. The type II and II A fibre areas increased significantly after enalapril treatment. We conclude that patients with chronic heart failurehave decreased activity of oxidative enzymes and of phosphorylase in skeletal muscle. They alsohave decreased capillarization in skeletal muscle. These changes were not influenced by enalapril treatment. The increase in muscle fibre area seen after enalapril treatment could be due to increased physical activity. The cause of increased muscle lactate dehydrogenase activity afterenalapril treatment needs further investigation.
Key Words: Heart failure • skeletal muscle • angiotensin converting enzyme inhibitor
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