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European Heart Journal 1997 18(6):971-980;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European society of Cardiology

Skeletal muscle alterations in patients with chronic heart failure

M. Schaufelberger*,, B. O. Eriksson{dagger}, G. Grimby{ddagger}, P. Held* and K. Swedberg*

*Department of Medicine, Sahlgrenska University Hospital, Göteborg University Sweden
{dagger}Department of Pediatrics, Östra University Hospital, Sahlgrenska University Hospital, Göteborg University Sweden
{ddagger}Department of Rehabilitation Medicine, Sahlgrenska University Hospital, Göteborg University Sweden

revised 13 September 1996; accepted 18 September 1996.

Correspondence: Maria Schaufelberger, MD, Department of Medicine, Östra University Hospital, S-416 85 Göteborg, Sweden

Abstract

AIMS: To investigate skeletal muscle in patients with chronic heart failure and controls, and relate skeletal muscle variables to functional class, exercise capacity, central haemodynamics, muscle strength and medical treatment.

METHODS: Biopsy from the lateral vastus muscle was obtained in 43 patients and 20 controls. Right sided heart catheterization was performed in 19 patients and maximal exercise testing in 26 patients. In nine patients muscle strength was measured. Patients had higher lactate levels, higher lactate dehydrogenase activity, and lower oxidative enzymes activity than controls. In patients, the percentage of type I fibres and capillarization were decreased while the percentage of type II B fibres were increased. Lactate dehydrogenase activity correlated with exercise capacity, muscle strength and right atrial pressure. Digoxin-treated patients had significantly lower oxidative enzyme activity than patients without digoxin treatment.

CONCLUSIONS: Patients with chronic heart failure have several skeletal muscle abnormalities. Central haemodynamics and medical treatment may, in addition to inactivity, be important in skeletal muscle changes.

Key Words: Heart failure • skeletal muscle • central haemodynamics • exercise capacity


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