scholarly journals Multimodality assessment of heart failure with preserved ejection fraction skeletal muscle reveals differences in the machinery of energy fuel metabolism

2021 ◽  
Author(s):  
Payman Zamani ◽  
Elizabeth A. Proto ◽  
Neil Wilson ◽  
Hossein Fazelinia ◽  
Hua Ding ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction ◽  
Fuel Metabolism

scholarly journals Skeletal muscle (dys)function in heart failure with preserved ejection fraction

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eng Leng Saw ◽  
Swetha Ramachandran ◽  
Maria Valero-Muñoz ◽  
Flora Sam
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

scholarly journals Skeletal Muscle Function, Structure, and Metabolism in Patients With Heart Failure With Reduced Ejection Fraction and Heart Failure With Preserved Ejection Fraction

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Tarek Bekfani ◽  
Mohamed Bekhite Elsaied ◽  
Steffen Derlien ◽  
Jenny Nisser ◽  
Martin Westermann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Fatty Acid ◽  
Ejection Fraction ◽  
Oral Anticoagulation ◽  
Muscle Function ◽  
Muscle Endurance ◽  
Acid Oxidation ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction

Background: Reduced exercise capacity in patients with heart failure (HF) could be partially explained by skeletal muscle dysfunction. We compared skeletal muscle function, structure, and metabolism among clinically stable outpatients with HF with preserved ejection fraction, HF with reduced ejection fraction, and healthy controls (HC). Furthermore, the molecular, metabolic, and clinical profile of patients with reduced muscle endurance was described. Methods: Fifty-five participants were recruited prospectively at the University Hospital Jena (17 HF with preserved ejection fraction, 18 HF with reduced ejection fraction, and 20 HC). All participants underwent echocardiography, cardiopulmonary exercise testing, 6-minute walking test, isokinetic muscle function, and skeletal muscle biopsies. Expression levels of fatty acid oxidation, glucose metabolism, atrophy genes, and proteins as well as inflammatory biomarkers were assessed. Mitochondria were evaluated using electron microscopy. Results: Patients with HF with preserved ejection fraction showed compared with HF with reduced ejection fraction and HC reduced muscle strength (eccentric extension: 13.3±5.0 versus 18.0±5.9 versus 17.9±5.1 Nm/kg, P =0.04), elevated levels of MSTN-2 (myostatin-2), FBXO-32 (F-box only protein 32 [Atrogin1]) gene and protein, and smaller mitochondrial size ( P <0.05). Mitochondrial function and fatty acid and glucose metabolism were impaired in HF-patients compared with HC ( P <0.05). In a multiple regression analysis, GDF-15 (growth and differentiation factor 15), CPT1B (carnitine palmitoyltransferase IB)-protein and oral anticoagulation were independent factors for predicting reduced muscle endurance after adjusting for age (log10 GDF-15 [pg/mL] [B, −54.3 (95% CI, −106 to −2.00), P =0.043], log10 CPT1B per fold increase [B, 49.3 (95% CI, 1.90–96.77), P =0.042]; oral anticoagulation present [B, 44.8 (95% CI, 27.90–61.78), P <0.001]). Conclusions: Patients with HF with preserved ejection fraction have worse muscle function and predominant muscle atrophy compared with those with HF with reduced ejection fraction and HC. Inflammatory biomarkers, fatty acid oxidation, and oral anticoagulation were independent factors for predicting reduced muscle endurance.

Abstract 15025: Visceral Adiposity and Muscle Composition in Heart Failure With Preserved Ejection Fraction and Association With Exercise Tolerance

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Wendy Ying ◽  
Kavita Sharma ◽  
Lisa R Yanek ◽  
Dhananjay Vaidya ◽  
Michael Schar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Exercise Tolerance ◽  
Nyha Class ◽  
Well Being ◽  
Liver Fat ◽  
Exercise Intolerance ◽  
Preserved Ejection Fraction ◽  
Intermuscular Fat

Introduction: Visceral adipose tissue (AT) promotes inflammation and adverse metabolic changes that mediate disease progression in heart failure with preserved ejection fraction (HFpEF). Exercise intolerance is a hallmark of HFpEF, but little is known about its relation to the extent and distribution of AT. We characterized regional AT distribution in HFpEF patients and controls and analyzed associations with comorbidities and exercise tolerance. Methods: MRI was performed to quantify epicardial, liver, abdominal and thigh skeletal muscle AT. We assessed NYHA class, 6-minute walk distance (6MWD), and global well-being score (GWBS). Multivariable linear and logistic regression models were used, adjusted for age, sex, and body surface area. Results: We studied 55 HFpEF patients (41 women, mean age 67) and 33 controls (21 women, mean age 57). Epicardial AT (4.6 vs 3.2mm, p = 0.03), thigh intermuscular fat (11.0 vs 5.0cm 2 , p < 0.01) and liver fat fraction (FF) (6.4% vs 4.1%, p = 0.04) were higher in HFpEF patients than controls. Women with HFpEF had higher abdominal (443.9 vs 297.3 cm 2 , p = 0.03) and thigh (228.6 vs 112.3 cm 2 , p < 0.001) subcutaneous AT than men. Higher thigh intermuscular fat was associated with higher blood pressure (β [SE] 14.1 [3.3], p < 0.001) and diabetes (β [SE] 2.6 [1.1], p = 0.02), and liver FF was associated with chronic kidney disease (β [SE] 1.6 [0.6], p = 0.01). Higher thigh intramuscular fat was associated with both higher NYHA class and shorter 6MWD, and higher thigh intermuscular AT FF was associated with higher NYHA class ( Table ). Higher epicardial AT and liver FF were associated with lower GWBS. Conclusions: HFpEF patients have increased epicardial, liver, and skeletal muscle fat compared to controls out of proportion to their body size, and adiposity was associated with worse exercise intolerance in HFpEF. These results provide the basis for further investigation into regional AT distribution in relation to HFpEF symptoms and pathophysiology.

scholarly journals Heart failure with preserved ejection fraction and skeletal muscle physiology

2017 ◽  
Vol 22 (2) ◽  
pp. 141-148 ◽  
Author(s):  
Stephen D. Farris ◽  
Farid Moussavi-Harami ◽  
April Stempien-Otero
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Muscle Physiology ◽  
Preserved Ejection Fraction

scholarly journals Heart failure with preserved ejection fraction induces molecular, mitochondrial, histological, and functional alterations in rat respiratory and limb skeletal muscle

2015 ◽  
Vol 17 (3) ◽  
pp. 263-272 ◽  
Author(s):  
T. Scott Bowen ◽  
Natale P. L. Rolim ◽  
Tina Fischer ◽  
Fredrik H. Baekkerud ◽  
Alessandra Medeiros ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

scholarly journals Impaired skeletal muscle vasodilation during exercise in heart failure with preserved ejection fraction

2016 ◽  
Vol 211 ◽  
pp. 14-21 ◽  
Author(s):  
Joshua F. Lee ◽  
Zachary Barrett-O'Keefe ◽  
Ashley D. Nelson ◽  
Ryan S. Garten ◽  
John J. Ryan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

Skeletal Muscle Capillary Hemodynamics in Rats with Heart Failure with Preserved Ejection Fraction

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Daniel M. Hirai ◽  
Ayaka Tabuchi ◽  
Jesse C. Craig ◽  
Trenton D. Colburn ◽  
Jacob T. Caldwell ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

scholarly journals Determinants of exercise intolerance in patients with heart failure and reduced or preserved ejection fraction

2015 ◽  
Vol 119 (6) ◽  
pp. 739-744 ◽  
Author(s):  
Mark J. Haykowsky ◽  
Corey R. Tomczak ◽  
Jessica M. Scott ◽  
D. Ian Paterson ◽  
Dalane W. Kitzman
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Ejection Fraction ◽  
Muscle Blood Flow ◽  
Exercise Intolerance ◽  
Healthy Controls ◽  
Preserved Ejection Fraction ◽  
Skeletal Muscle Function ◽  
Skeletal Morphology ◽  
Patients With Heart Failure

This mini-review summarizes the literature regarding the mechanisms of exercise intolerance in patients with heart failure and reduced or preserved ejection fraction (HFREF and HFPEF, respectively). Evidence to date suggests that the reduced peak pulmonary oxygen uptake (pulm V̇o2) in patients with HFREF compared with healthy controls is due to both central (reduced convective O2 transport) and peripheral factors (impaired skeletal muscle blood flow, decreased diffusive O2 transport coupled with abnormal skeletal morphology, and metabolism). Although central and peripheral impairments also limit peak pulm V̇o2 in HFPEF patients compared with healthy controls, emerging data suggest that the latter may play a relatively greater role in limiting exercise performance in these patients. Unlike HFREF, currently there is limited evidence-based therapies that improve exercise capacity in HFPEF patients, therefore future studies are required to determine whether interventions targeted to improve peripheral vascular and skeletal muscle function result in favorable improvements in peak pulm and leg V̇o2 and their determinants in HFPEF patients.

Sign in / Sign up

Export Citation Format

Share Document