Skeletal muscle and heart failure – What is the relationship between central versus peripheral affections?

Background and aimHeart failure is considered as a systemic disease as beside the heart, skeletal muscle is affected.Methods and resultsIn this retrospective case-control study 64 men and 15 women with heart failure as well as an individually pairwise matched sample by sex, age and body mass index of healthy individuals from the COmPLETE cohort study performed an exhaustive cardiopulmonary exercise test, strength tests and anthropometric measurements. V̇O2peak was 28.6% lower in male and 24.6% lower in female patients with heart failure as compared to healthy controls. Strength parameters are significantly higher for counter movement jump in male subjects. In females, significant differences were detected for mid-thigh pull in healthy versus patients with heart failure. Skeletal muscle mass of patients was in male as well as female 3.7% lower than in controls. Furthermore, the function of skeletal muscle seems impaired as the ability to accelerate is significantly lower in affected male with a heart pathology.ConclusionIt seems that severe affections (approx. 25 to 30%) on cardiocirculatory level are associated with moderate to low affections on functional and structural capacity on skeletal muscle level. Further, as in the male cohort with a heart pathology acceleration meaning ‘fast’ contracting is impaired, it is suggested, that the central limitations respectively the low perfusion of skeletal muscle over years yield to adaptions on muscle cell level ingoing with a decreased ability of fast contracting. It is therefore suggested, that the central circulatory limitations in patients with heart failure, respectively the low perfusion of skeletal muscle over years, promote maladaptation's in the periphery.