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CLINICAL STUDIES

Skeletal muscle response to short endurance training in heart transplant recipients

Eliane Lampert, MD^*, Bertrand Mettauer, MD, Hans Hoppeler, MD, Anne Charloux, MD^*, Arnaud Charpentier, MD and Jean Lonsdorfer, MD^*

^* Service des Explorations Fonctionnelles Respiratoires et de l’Exercice, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Service des Explorations Fonctionnelles Cardiovasculaires et Service de Chirurgie Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Department of Anatomy, University of Bern, Bern, Switzerland

Manuscript received June 11, 1997; revised manuscript received April 6, 1998, accepted April 22, 1998.

Address for correspondence: Dr. Eliane Lampert, Service des Explorations Fonctionnelles Respiratoires et de l’Exercice, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg Cedex, France
Eliane.Lampert{at}chru.strasbourg.fr

Objectives. We sought to examine the effects of endurance training on the ultrastructural characteristics of skeletal muscle in heart transplant recipients (HTRs) and age-matched control subjects (C).

Background. Deconditioning is one of the factors involved in the peripheral limitation of exercise capacity of HTRs, and training has proven to be beneficial.

Methods. Biopsies of the vastus lateralis muscle, analyzed by ultrastructural morphometry, and quadriceps muscle cross-sectional area, assessed by computed tomography (CT), were performed in 12 HTRs and 7 age-matched C before and 6 weeks after an endurance training program. Maximal oxygen uptake (peak O₂) was determined by an incremental exercise test. Additionally muscle biopsies were performed before and after a 6-week control period in four HTRs to check for spontaneous improvement.

Results. Training resulted in similar increases in peak O₂ (11% in HTRs, 8.5% in C), ventilatory threshold (23% in HTRs, 32% in C) and total endurance work (54% in HTRs, 31% in C). Volume density of total mitochondria increased significantly (26% in HTRs, 33% in C) with a predominant increase of subsarcolemmal mitochondrial volume density (74% in HTRs, 70% in C). The capillary/fiber ratio increased by 19% in C only. In the nontrained group, none of the structural markers was spontaneously modified.

Conclusions. Six weeks of endurance training in HTRs and C led to similar improvements of aerobic work capacity. However, the decreased muscular capillary network in HTRs remained unchanged with training. Immunosuppressive therapy might be responsible for the discrepancy between the normal mitochondrial content and the reduced capillary supply of these patients.

Abbreviations and Acronyms   C = age-matched control subjects   CT = computed tomography   HTRs = heart transplant recipients   TGF-ß = transforming growth factor-beta   VEGF = vascular endothelial growth factor   O2 = oxygen uptake

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