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CLINICAL STUDY: HEART FAILURE

Deconditioning fails to explain peripheral skeletal muscle alterations in men with chronic heart failure

Brian D. Duscha, MS^*,*, Brian H. Annex, MD^*,, Howard J. Green, PhD, Anne M. Pippen, MS^* and William E. Kraus, MD

^* Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA
Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, USA
Department of Medicine, Division of Cardiology, Durham Veterans Administration Medical Center, Durham, North Carolina, USA
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada

Manuscript received August 13, 2001; revised manuscript received November 14, 2001, accepted January 9, 2002.

^* Reprint requests and correspondence: Brian D. Duscha, MS, Duke University Medical Center, Box 3022, Duke Center for Living, Durham, North Carolina 27710, USA.

OBJECTIVES: It remains controversial whether the skeletal muscle alterations in chronic heart failure (CHF) are due to disease pathophysiology or result from chronic deconditioning. The purpose of this study was to compare the skeletal muscle of CHF patients to peak oxygen consumption (peak VO₂) matched sedentary controls.

BACKGROUND: It has been established that skeletal muscle abnormalities are related to the exercise intolerance observed in patients with CHF.

METHODS: We studied the skeletal muscle of sedentary controls and patients with CHF matched for age, gender and peak VO₂.

RESULTS: Hypothesis testing for the effects of group (CHF vs. normal), gender, and the interaction group x gender were performed. For capillary density only gender (p = 0.002) and the interaction of group x gender (p = 0.007) were significantly different. For 3-hydroxyl coenzyme A (CoA) dehydrogenase only group effect (p = 0.004) was significantly different. Mean values for capillary density were 1.46 ± 0.28 for CHF men versus 1.87 ± 0.32 for sedentary control men, 1.40 ± 0.32 for CHF women versus 1.15 ± 0.35 for sedentary control women. The activities for 3-hydroxyl CoA dehydrogenase were 3.09 ± 0.88 for CHF men versus 4.05 ± 0.42 for sedentary control men, 2.93 ± 0.72 for CHF women versus 3.51 ± 0.78 for sedentary control women.

CONCLUSIONS: This study suggests that women and men adapt to CHF differently: men develop peripheral skeletal muscle abnormalities that are not attributable to deconditioning; women do not develop the same pathologic responses in skeletal muscle when compared with normal women matched for aerobic capacity.

Abbreviations and Acronyms   CHF   chronic heart failure   CoA   coenzyme A   LVEF   left ventricular ejection fraction   VO2   oxygen consumption

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