CHF (chronic heart failure) is associated with a prolonged recovery of skeletal muscle energy stores following submaximal exercise, limiting the ability to perform repetitive daily activities. However, the pathophysiological background of this impairment is not well established. The aim of the present study was to investigate whether muscle metabolic recovery following submaximal exercise in patients with CHF is limited by O2 delivery or O2 utilization. A total of 13 stable CHF patients (New York Heart Association classes II–III) and eight healthy subjects, matched for age and BMI (body mass index), were included. All subjects performed repetitive submaximal dynamic single leg extensions in the supine position. Post-exercise PCr (phosphocreatine) resynthesis was assessed by 31P-MRS (magnetic resonance spectroscopy). NIRS (near-IR spectroscopy) was applied simultaneously, using the rate of decrease in HHb (deoxygenated haemoglobin) as an index of post-exercise muscle re-oxygenation. As expected, PCr recovery was slower in CHF patients than in control subjects (time constant, 47±10 compared with 35±12 s respectively; P=0.04). HHb recovery kinetics were also prolonged in CHF patients (mean response time, 74±41 compared with 44±17 s respectively; P=0.04). In the patient group, HHb recovery kinetics were slower than PCr recovery kinetics (P=0.02), whereas no difference existed in the control group (P=0.32). In conclusion, prolonged metabolic recovery in CHF patients is associated with an even slower muscle tissue re-oxygenation, indicating a lower O2 delivery relative to metabolic demands. Therefore we postulate that the impaired ability to perform repetitive daily activities in these patients depends more on a reduced muscle blood flow than on limitations in O2 utilization.
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February 01 2010
Skeletal muscle metabolic recovery following submaximal exercise in chronic heart failure is limited more by O2 delivery than O2 utilization
Hareld M.C. Kemps;
*Department of Cardiology, Máxima Medical Centre, Veldhoven, The Netherlands
†Department of Sports Medicine, Máxima Medical Centre, Veldhoven, The Netherlands
Correspondence: Dr Hareld M.C. Kemps (email [email protected]).
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Jeanine J. Prompers;
Jeanine J. Prompers
‡Department of Biomedical Engineering, Biomedical NMR, Eindhoven University of Technology, Eindhoven, The Netherlands
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Bart Wessels;
Bart Wessels
‡Department of Biomedical Engineering, Biomedical NMR, Eindhoven University of Technology, Eindhoven, The Netherlands
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Wouter R. De Vries;
Wouter R. De Vries
§Section Rehabilitation and Sports Medicine, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
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Maria L. Zonderland;
Maria L. Zonderland
∥Division Heart & Lungs, Department of Medical Physiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Eric J.M. Thijssen;
Eric J.M. Thijssen
*Department of Cardiology, Máxima Medical Centre, Veldhoven, The Netherlands
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Klaas Nicolay;
Klaas Nicolay
‡Department of Biomedical Engineering, Biomedical NMR, Eindhoven University of Technology, Eindhoven, The Netherlands
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Goof Schep;
Goof Schep
†Department of Sports Medicine, Máxima Medical Centre, Veldhoven, The Netherlands
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Pieter A.F.M. Doevendans
Pieter A.F.M. Doevendans
¶Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Publisher: Portland Press Ltd
Received:
April 14 2009
Revision Received:
June 04 2009
Accepted:
June 12 2009
Accepted Manuscript online:
June 12 2009
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2010 Biochemical Society
2010
Clin Sci (Lond) (2010) 118 (3): 203–210.
Article history
Received:
April 14 2009
Revision Received:
June 04 2009
Accepted:
June 12 2009
Accepted Manuscript online:
June 12 2009
Citation
Hareld M.C. Kemps, Jeanine J. Prompers, Bart Wessels, Wouter R. De Vries, Maria L. Zonderland, Eric J.M. Thijssen, Klaas Nicolay, Goof Schep, Pieter A.F.M. Doevendans; Skeletal muscle metabolic recovery following submaximal exercise in chronic heart failure is limited more by O2 delivery than O2 utilization. Clin Sci (Lond) 1 February 2010; 118 (3): 203–210. doi: https://doi.org/10.1042/CS20090220
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