PMID- 8705758
OWN - NLM
STAT- MEDLINE
DCOM- 19960912
LR  - 20190503
IS  - 1355-6037 (Print)
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 75
IP  - 4
DP  - 1996 Apr
TI  - Ammonia response to exercise in patients with congestive heart failure.
PG  - 343-8
AB  - OBJECTIVE: To assess energy depletion in skeletal muscle in patients with 
      congestive heart failure by measuring blood purine metabolites during exercise 
      and, at the same time, determine the implications of the ammonia response to 
      exercise in these patients. SETTING: Tottori University Hospital, Yonago, Japan. 
      PATIENTS: 49 heart failure patients (New York Heart Association (NYHA) grades 
      I-III) and 16 normal subjects. MAIN OUTCOME MEASURES: Blood lactate, ammonia, and 
      hypoxanthine levels were measured during exercise with expired gas analysis. 
      RESULTS: In normal exercising subjects as well as in each heart failure subgroup, 
      the ammonia threshold was significantly higher than both the lactate threshold 
      [control: 21.8 (SD 5.3) v 17.4 (3.3) ml/kg/min; NYHA class I: 18.9 (3.8) v 15.5 
      (2.6); class II: 14.8 (2.5) v 12.7 (2.4); class III: 13.5 (2.6) v 11.8 (2.5)] and 
      the ventilatory threshold (P < 0.01). The difference between the ammonia and 
      lactate thresholds was noted in all normal subjects and in all heart failure 
      patients. The ammonia threshold, however, was significantly lower in heart 
      failure patients than in normal subjects and it decreased with increasing NYHA 
      class (P < 0.01). Maximum ammonia levels were lower in the heart failure group 
      and decreased further with higher NYHA classifications [control: 198 (52) mg/dl; 
      NYHA class I: 170 (74); class II: 134 (58); class III: 72 (15); P < 0.01]. There 
      were significant correlations between maximum ammonia values and maximum lactate, 
      oxygen consumption, and hypoxanthine levels (r = 0.74, 0.48, and 0.87, 
      respectively; P < 0.001). CONCLUSIONS: The ammonia threshold may reflect the 
      onset of ATP depletion in exercising skeletal muscles, as opposed to the onset of 
      anaerobic respiration. It seems therefore that energy depletion in skeletal 
      muscles during exercise occurs after attaining the anaerobic threshold. Both 
      aerobic and anaerobic capacities of skeletal muscle are reduced in patients with 
      congestive heart failure.
FAU - Ogino, K
AU  - Ogino K
AD  - First Department of Internal Medicine, Tottori University School of Medicine, 
      Yonago, Japan.
FAU - Osaki, S
AU  - Osaki S
FAU - Kitamura, H
AU  - Kitamura H
FAU - Noguchi, N
AU  - Noguchi N
FAU - Hisatome, I
AU  - Hisatome I
FAU - Matsumoto, T
AU  - Matsumoto T
FAU - Omodani, H
AU  - Omodani H
FAU - Kato, M
AU  - Kato M
FAU - Kinugawa, T
AU  - Kinugawa T
FAU - Miyakoda, H
AU  - Miyakoda H
FAU - Kotake, H
AU  - Kotake H
FAU - Mashiba, H
AU  - Mashiba H
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Hypoxanthines)
RN  - 0 (Lactates)
RN  - 2TN51YD919 (Hypoxanthine)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 7664-41-7 (Ammonia)
RN  - 8L70Q75FXE (Adenosine Triphosphate)
SB  - IM
MH  - Adenosine Triphosphate/metabolism
MH  - Ammonia/*blood
MH  - Exercise/*physiology
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/*blood/metabolism
MH  - Humans
MH  - Hypoxanthine
MH  - Hypoxanthines/blood
MH  - Lactates/blood
MH  - Lactic Acid
MH  - Male
MH  - Middle Aged
MH  - Muscle, Skeletal/metabolism
MH  - Oxygen Consumption
PMC - PMC484307
EDAT- 1996/04/01 00:00
MHDA- 1996/04/01 00:01
PMCR- 1999/04/01
CRDT- 1996/04/01 00:00
PHST- 1996/04/01 00:00 [pubmed]
PHST- 1996/04/01 00:01 [medline]
PHST- 1996/04/01 00:00 [entrez]
PHST- 1999/04/01 00:00 [pmc-release]
AID - 10.1136/hrt.75.4.343 [doi]
PST - ppublish
SO  - Heart. 1996 Apr;75(4):343-8. doi: 10.1136/hrt.75.4.343.