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Changes in the peripheral circulation in heart failure

H Drexler1

  • 1Med. Klinik III, University of Freiburg, Germany.

Current Opinion in Cardiology
|May 1, 1995
PubMed
Summary
This summary is machine-generated.

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Chronic heart failure impairs skeletal muscle function through endothelial dysfunction and reduced mitochondrial oxygen utilization. These factors contribute to poor exercise capacity and strength, with only partial recovery after heart transplantation.

Area of Science:

  • Cardiology
  • Physiology
  • Vascular Biology

Background:

  • Chronic heart failure (CHF) involves neurohumoral activation affecting peripheral circulation and skeletal muscle.
  • Impaired peripheral perfusion in CHF is linked to increased sympathetic tone and vascular stiffness.
  • The endothelium plays a crucial role in skeletal muscle perfusion, with dysfunction observed in CHF.

Purpose of the Study:

  • To investigate endothelial function in resistance and conductance vessels in patients with CHF.
  • To examine skeletal muscle metabolic and structural alterations in CHF.
  • To assess the impact of heart transplantation on these abnormalities.

Main Methods:

  • Assessed endothelium-dependent dilation in resistance and conductance vessels.

Related Experiment Videos

  • Evaluated skeletal muscle mitochondrial oxidative capacity and metabolic profiles.
  • Measured muscle cross-sectional area and strength.
  • Compared pre- and post-heart transplantation parameters.

    • Main Results:

    • Endothelium-dependent dilation was blunted in resistance vessels and attenuated in conductance vessels in CHF patients.
    • Skeletal muscle metabolic abnormalities stemmed from impaired mitochondrial oxygen utilization, not delivery.
    • Reduced oxidative capacity led to enhanced glycolytic metabolism, and smaller muscle size contributed to lower strength.

    Conclusions:

    • Endothelial dysfunction contributes to impaired tissue perfusion in CHF.
    • Skeletal muscle in CHF exhibits reduced oxidative capacity and altered metabolism, impacting endurance.
    • Heart transplantation provided only partial improvement in bioenergetic abnormalities 15 months post-transplant.