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1 Division of Cardiology, Department of Medicine, and 2 Department of Cell Biology, Duke University Medical Center, Durham, North Carolina 27710; 3 Henry Ford Heart and Vascular Institute, Detroit, Michigan 48202-3006; and 4 Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1
Men with chronic heart failure (CHF) have alterations
in their skeletal muscle that are partially responsible for a decreased exercise tolerance. The purpose of this study was to investigate whether skeletal muscle alterations in women with CHF are similar to
those observed in men and if these alterations are related to exercise
intolerance. Twenty-five men and thirteen women with CHF
performed a maximal exercise test for evaluation of peak oxygen consumption (
O2) and resting left
ventricular ejection fraction, after which a biopsy of the vastus
lateralis was performed. Twenty-one normal subjects (11 women, 10 men)
were also studied. The relationship between muscle markers and peak
O2 was consistent for CHF men and women.
When controlling for gender, analysis showed that oxidative enzymes and
capillary density are the best predictors of peak O2. These results indicate
that aerobically matched CHF men and women have no differences in
skeletal muscle biochemistry and histology. However, when CHF groups
were separated by peak exercise capacity of 4.5 metabolic equivalents
(METs), CHF men with peak O2 >4.5
METs had increased citrate synthase and 3-hydroxyacyl-CoA dehydrogenase
compared with CHF men with peak O2 <4.5
METs. CHF men with a lower peak O2 had
increased capillary density compared with men with higher peak
O2. These observations were not
reproduced in CHF women. This suggests that differences may exist
in how skeletal muscle adapts to decreasing peak
O2 in patients with CHF.
oxygen consumption; exercise; capillary density
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