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1 Division of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut 06102; and 2 Department of Surgery Research, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, New Jersey 07103
Heart failure
(HF) is a slow progressive syndrome characterized by low cardiac output
and peripheral metabolic, biochemical, and histological alterations.
Protein loss and reduced protein turnover occur with aging, but the
consequences of congestive HF (CHF) superimposed on the normal aging
response are unknown. This study has two objectives: 1) to
determine whether there was a difference between older age-matched
controls and those with stable HF (i.e., ischemic pathology) in
whole body protein turnover and 2) to determine whether
protein metabolism in liver and skeletal muscle protein turnover is
impacted by CHF. We measured the whole body protein synthesis rate with
a U-15N-labeled algal protein hydrolysate in 10 patients with CHF and in 10 age-matched controls. Muscle fractional
synthesis rate of lateral vastus muscle was determined with
[U-13C]alanine on muscle biopsies obtained by a standard
percutaneous needle biopsy technique. Fractional synthesis rates of
five plasma proteins of hepatic origin (fibrinogen, complement C-3,
ceruloplasmin, transferrin, and very low-density lipoprotein
apoliprotein B-100) were determined by using
2H5-labeled L-phenylalanine as
tracer. Results showed that whole body protein synthesis rate was
reduced in CHF patients (3.09 ± 0.19 vs. 2.25 ± 0.71 g
protein · kg
1 · day
1,
P < 0.05) as was muscle fractional synthesis rate
(3.02 ± 0.58 vs. 1.33 ± 0.71%/day, P < 0.05) and very low-density lipoprotein apoliprotein B-100 (265 ± 25 vs. 197 ± 16%/day, P < 0.05). CHF patients
were hyperinsulinemic (9.6 ± 3.1 vs. 47.0 ± 7.8 µU/ml, P < 0.01). The results were compared with those found
with bed rest patients. In conclusion, protein turnover is depressed in CHF patients, and both skeletal muscle and liver are impacted. These
results are similar to those found with bed rest, which suggests that
inactivity is a factor in depressed protein metabolism.
protein synthesis; turnover; muscle; liver
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