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[Remodeling myocardium and skeletal muscle in chronic heart failure]
Insights
Chronic heart failure (CHF) causes similar tissue and cellular changes in both the heart muscle (myocardium) and skeletal muscles. These changes worsen as CHF progresses, indicating a systemic effect beyond the heart.
Area of Science:
- Cardiovascular Biology
- Skeletal Muscle Physiology
- Pathology
Context:
- Chronic heart failure (CHF) is traditionally studied via myocardial and peripheral vessel remodeling.
- The adaptive role of remodeling in skeletal muscle during CHF remains unclear.
- Investigating shared morphological changes is crucial for understanding CHF progression.
Purpose:
- To investigate morphological changes in the myocardium and skeletal muscle in CHF patients.
- To examine the interrelations between myocardial and skeletal muscle conditions in CHF.
- To compare tissue, cellular, and subcellular changes in both muscle types.
Summary:
- Morphological changes in the myocardium and skeletal muscle are similar across tissue, cellular, and subcellular levels in CHF patients.
- Hypertrophy and fiber heteromorphism increase in both muscle types as CHF severity (NYHA class) advances.
- A significant correlation (r = 0.57, p < 0.05) exists between the cellular-stromal ratio changes in the myocardium and skeletal muscle.
Impact:
- Findings suggest CHF involves systemic skeletal muscle pathology, not just cardiac remodeling.
- Highlights the potential for shared therapeutic targets for both cardiac and skeletal muscle dysfunction in CHF.
- Provides novel insights into the pathophysiology of chronic heart failure and its systemic impact.
Abstract:
The spread and progression of chronic heart failure (CHF) is viewed presently from the standpoint of remodeling the myocardium and skeletal peripheral vessels. However, it is not clear yet, if such remodeling is a common adaptive mechanism in CHF for the myocardium and skeletal muscle. The study aim was to investigate the morphological changes in the myocardium and their interrelations with the skeletal muscle condition in CHF patients. For this purpose the biopsy materials of the left ventricle and pectoral muscles obtained from 36 patients with CHF (functional classes I-IV according to NYHA) of various etiologies as well as biopsy materials of the rectus abdominal muscle obtained from 8 patients without CHF were examined by light and electron microscopy. It was established that the development and progression of CHF is accompanied by similar changes in the morphology of the myocardium and skeletal muscle at the tissue, cellular and subcellular levels. As CHF aggravates, the manifestations of hypertrophy and heteromorphism of tissue fibers equally progress in the myocardium and skeletal muscle. A reliable correlation was detected between changes of cellular-stromal ratio in the myocardium and in the skeletal muscle (r = 0.57; p < 0.05).