Skeletal muscle metabolism during exercise under ischemic conditions in congestive heart failure. Evidence for abnormalities unrelated to blood flow.
Key result
Congestive heart failure patients exhibited significantly lower skeletal muscle pH (6.65 vs 6.97, p<0.002) during aerobic exercise compared to healthy controls.
Why the study?
Does skeletal muscle metabolism differ during exercise under ischemic conditions in patients with congestive heart failure compared to healthy controls?
Population
9 patients with mild-to-moderate congestive heart failure and 9 age- and size-matched healthy control…
Comparison
Repetitive submaximal finger flexion exercise… vs Healthy control volunteers performing the same…
Design
Case-control
Authors
Discussion
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Implication
May indicate intrinsic muscle metabolic defects in CHF; leaves open whether metabolic therapies improve exercise capacity.
Key Points
- This study aims to investigate skeletal muscle metabolism in patients with congestive heart failure during exercise and determine the role of blood flow in observed abnormalities.
- Nine patients with mild-to-moderate congestive heart failure and nine healthy controls were studied.
- Participants performed repetitive finger flexion exercises under both aerobic and ischemic conditions.
- Skeletal muscle metabolism was assessed using 31P nuclear magnetic resonance.
- Patients with congestive heart failure exhibited lower pH values (6.65 vs. 6.97, p<0.002).
- Phosphocreatine concentrations were significantly lower in patients (0.59 vs. 0.79, p<0.002).
- Increased lactate production and ATP consumption rates were observed in congestive heart failure patients.
Study Design
Type
Case-Control (n=18)
Structured PICO
Does skeletal muscle metabolism differ during exercise under ischemic conditions in patients with congestive heart failure compared to healthy controls?
P
Population
9 patients with mild-to-moderate congestive heart failure and 9 age- and size-matched healthy control volunteers (n=18)
I
Intervention
Repetitive submaximal finger flexion exercise under aerobic and ischemic conditions
C
Comparator
Healthy control volunteers performing the same exercise protocol
O
Outcome
Skeletal muscle metabolism assessed by 31P nuclear magnetic resonance (pH values, phosphocreatine concentrations, lactate production, and ATP consumption)surrogate
Main Result
Absolute Event Rate: 6.65% vs 6.97%
p-value: p=<0.002
Patients with congestive heart failure exhibit increased glycolytic metabolism and reduced metabolic efficiency in exercising skeletal muscle, which cannot be explained by impaired blood flow or oxygen delivery alone.
Cite This Study
Massie et al. (1988) conducted a case-control in Congestive heart failure (n=18). Repetitive submaximal finger flexion exercise under aerobic and ischemic conditions vs. Healthy control volunteers was evaluated on Skeletal muscle pH values during steady-state aerobic exercise (p=<0.002). Congestive heart failure patients exhibited significantly lower skeletal muscle pH (6.65 vs 6.97, p<0.002) during aerobic exercise compared to healthy controls.