Copyright © 2001 by the European Society of Cardiology.
Preservation of exercise capacity and lack of peripheral changes in asymptomatic patients with severely impaired left ventricular function
a Cardiology Department, Kent and Sussex Hospital, Tunbridge Wells, Kent, U.K.
b Royal Brompton Hospital and National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, London, U.K.
revised July 10, 2000; accepted July 12, 2000
Abstract
Aims To establish the extent, if any, of peripheral changes in asymptomatic patients with severe left ventricular dysfunction.
Methods and Results Nine asymptomatic and nine symptomatic patients with left ventricular ejection fraction, <25%, matched for age and left ventricular ejection fraction (asymptomatic vs symptomatic, age: 52±1·5 vs 55·9±2·5 years [Mean±SEM], left ventricular ejection fraction: 16±2 vs 19±2%P=0·23 and 0·48, respectively) were studied and compared with 26 age-matched normal controls. We assessed exercise capacity, leg blood flow (occlusion plethysmography), respiratory muscle strength, quadriceps maximal isometric strength, fatigue and CT cross-sectional muscle area at mid thigh. Fatigue was expressed as the percentage reduction in maximal strength following a 20min fatiguing protocol. There was a graded increase in peak oxygen consumption comparing symptomatic, asymptomatic and control groups (16·6±1·3 vs 27·1±1·6 vs 32·8±1·3ml.min–1.kg–1respectively, ANOVA P<0·0001). Between the three groups there was significant variation in muscle strength (P<0·0001), endurance (P=0·0002) and cross-sectional area (P=0·0003) and in peak blood flow (P=0·027) and respiratory muscle strength (P<0·05). When asymptomatic patients and controls were compared no significant differences existed.
Conclusions Patients with severe left ventricular dysfunction may have near normal exercise capacity and no peripheral changes. Exercise capacity may depend less upon left ventricular function than on the presence or absence of peripheral factors.
Key Words: Heart failure, exercise capacity, skeletal muscle
f1 Correspondence: Professor A. J. S. Coats, Department of Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, U.K.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Mezzani, U. Corra, C. Andriani, A. Giordano, R. Colombo, and P. Giannuzzi Anaerobic and aerobic relative contribution to total energy release during supramaximal effort in patients with left ventricular dysfunction J Appl Physiol, January 1, 2008; 104(1): 97 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J A Laukkanen, S Kurl, J T Salonen, T A Lakka, and R Rauramaa Peak oxygen pulse during exercise as a predictor for coronary heart disease and all cause death Heart, September 1, 2006; 92(9): 1219 - 1224. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Adams and N. D. Vaziri Skeletal muscle dysfunction in chronic renal failure: effects of exercise Am J Physiol Renal Physiol, April 1, 2006; 290(4): F753 - F761. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. H.M.K. Uszko-Lencer, F. Bothmer, P. E.J. van Pol, and A. M.W.J. Schols Measuring body composition in chronic heart failure: A comparison of methods Eur J Heart Fail, March 1, 2006; 8(2): 208 - 214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A L Clark Origin of symptoms in chronic heart failure Heart, January 1, 2006; 92(1): 12 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E De Caro, F Fioredda, M G Calevo, A Smeraldi, M Saitta, G Hanau, M Faraci, F Grisolia, G Dini, G Pongiglione, et al. Exercise capacity in apparently healthy survivors of cancer Arch. Dis. Child., January 1, 2006; 91(1): 47 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. M. Conraads, P. Beckers, J. Vaes, M. Martin, V. Van Hoof, C. De Maeyer, N. Possemiers, F. L. Wuyts, and C. J. Vrints Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure Eur. Heart J., October 2, 2004; 25(20): 1797 - 1805. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Lipshultz and S. D. Colan Cardiovascular Trials in Long-Term Survivors of Childhood Cancer J. Clin. Oncol., March 1, 2004; 22(5): 769 - 773. [Full Text] [PDF]
|
|
|
|
|
|
K. Dickstein What should be the focus in the management of patients with heart failure? The importance of peripheral vision Eur. Heart J., March 1, 2001; 22(5): 355 - 356. [PDF]
|
|