PMID- 9068400
OWN - NLM
STAT- MEDLINE
DCOM- 19970328
LR  - 20190503
IS  - 1355-6037 (Print)
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 77
IP  - 2
DP  - 1997 Feb
TI  - Abnormalities of skeletal muscle metabolism in patients with chronic heart 
      failure: evidence that they are present at rest.
PG  - 159-63
AB  - OBJECTIVE: To investigate abnormalities of skeletal muscle metabolism in patients 
      with congestive heart failure. SETTING: A university teaching hospital. METHODS: 
      43 patients (22 New York Heart Association (NYHA) grade II, 21 grade III) and 10 
      controls were studied. A forearm model of muscle metabolism was used, with a 
      cannula inserted retrogradely into an antecubital vein of the dominant forearm. 
      Maximum voluntary contraction (MVC) was measured using handgrip dynamometry. 
      Subjects performed handgrip exercise, 5 s contraction followed by 5 s rest for 5 
      min at 25%, 50%, and 75% of MVC or until exhaustion. Blood was taken at rest and 
      0 and 2 min after exercise for measurement of lactate and ammonia. After 30 min 
      the procedure was repeated with fixed workloads of 7 kg, 14 kg, and 21 kg. 
      RESULTS: MVC (kg, mean (SEM)) was lower in patients than in controls (control 
      42.45 (2.3); NYHA II 34.13 (1.3), P = 0.003; NYHA III 33.13 (1.94), P = 0.008). 
      Resting lactate (mmol/l) was higher in patients than controls (control 0.65 
      (0.06); NYHA II 0.84 (0.08), P = 0.13; NYHA III 1.18 (0.1), P = 0.002). Resting 
      ammonia (mumol/l) was higher in NYHA III (65.7 (6.0)) than in NYHA II (48.0 
      (3.7), P = 0.016); no difference was found between controls (48.0 (7.1)) and 
      patients. The overall lactate and ammonia response to exercise was greater in 
      NYHA III than in NYHA II and controls (P < 0.05). At volitional exhaustion, peak 
      lactate (mmol/l: NYHA III 3.31 (0.26); NYHA II 2.56 (0.16); controls 2.71 (0.22); 
      P = 0.022 NYHA III v NYHA II) and ammonia (mumol/l: NYHA III) 126.4 (8.97); NYHA 
      II 92.9 (7.23); controls 109 (16.3); P = 0.006 NYHA III v NYHA II) were higher in 
      severe congestive heart failure. CONCLUSIONS: Skeletal muscle metabolism is 
      abnormal at rest in congestive heart failure. During exercise, the degree of 
      metabolic abnormality is related to the symptomatic status of the patient.
FAU - Andrews, R
AU  - Andrews R
AD  - Cardiovascular Medicine, University Hospital, Nottingham.
FAU - Walsh, J T
AU  - Walsh JT
FAU - Evans, A
AU  - Evans A
FAU - Curtis, S
AU  - Curtis S
FAU - Cowley, A J
AU  - Cowley AJ
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 33X04XA5AT (Lactic Acid)
RN  - 7664-41-7 (Ammonia)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ammonia/blood
MH  - Female
MH  - Forearm
MH  - Hand Strength
MH  - Heart Failure/*metabolism
MH  - Humans
MH  - Lactic Acid/blood
MH  - Male
MH  - Middle Aged
MH  - Muscle, Skeletal/*metabolism
PMC - PMC484666
EDAT- 1997/02/01 00:00
MHDA- 1997/02/01 00:01
PMCR- 2000/02/01
CRDT- 1997/02/01 00:00
PHST- 1997/02/01 00:00 [pubmed]
PHST- 1997/02/01 00:01 [medline]
PHST- 1997/02/01 00:00 [entrez]
PHST- 2000/02/01 00:00 [pmc-release]
AID - 10.1136/hrt.77.2.159 [doi]
PST - ppublish
SO  - Heart. 1997 Feb;77(2):159-63. doi: 10.1136/hrt.77.2.159.