The influence of muscle mass, strength, fatigability and blood flow on exercise capacity in cachectic and non-cachectic patients with chronic heart failure

S. D. Anker, J. W. Swan, M. Volterrani, T. P. Chua, A. L. Clark, P. A. Poole-Wilson, A. J S Coats

Research output: Contribution to journalArticle

Abstract

Background. The influence of age, skeletal muscle function and peripheral blood flow on exercise capacity in chronic heart failure patients is controversial, possibly due to variations in skeletal muscle atrophy. Methods and results. To assess predictors of exercise capacity in patients with clinical cardiac cachexia, we studied 16 cachectic and 39 non-cachectic male chronic heart failure patients of similar age and ejection fraction. All cachectic patients were wasted (% ideal body weight: 81.2 ± 1.9 vs 105.2 ± 2.1, P <0.0001, mean ± SEM) and had documented weight loss (5-30 kg). Peak oxygen consumption (149 ± 1.4 vs 16.3 ± 0.6 ml.kg-1.min-1, resting, and peak blood flow (plethysmography) and 20 min fatigability (% baseline strength) were all similar between the two groups. Quadriceps strength, muscle size (all P <0.0001), strength per unit muscle (right: P <0.05; left: P <0.001) and 5 min fatigability (P <0.05) were all lower in cachectic patients. In non-cachectic patients, age (R = 0.48) and quadriceps strength (R = 0.43, all P <0.01) predicted peak oxygen consumption. Only in cachectic patients did peak blood flow predict peak oxygen consumption significantly (R = 0.72, P = 0.005), whereas age and strength did not. Similar findings were confirmed using other previously published definitions of cardiac cachexia. Conclusions. The predictors of exercise capacity change with the development of cardiac cachexia from age and strength to peak blood flow. This shift may be caused by additional endocrine or catabolic abnormalities active in end stage heart failure.

Original languageEnglish
Pages (from-to)259-269
Number of pages11
JournalEuropean Heart Journal
Volume18
Issue number2
Publication statusPublished - 1997

Keywords

  • Cardiac cachexia
  • Chronic heart failure
  • Fatigability
  • Leg blood flow
  • Maximal oxygen consumption
  • Muscle strength

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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