Skeletal muscle response to exercise training in congestive heart failure.
Skeletal muscle response to exercise training in congestive heart failure.
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骨骼肌对充血性心力衰竭运动训练的反应。
DOI：
10.1172/jci114771
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Icenogle,MV
中科院分区：
文献类型：
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作者：
Minotti,JR;Johnson,EC;Hudson,TL;Zuroske,G;Murata,G;Fukushima,E;Cagle,TG;Chick,TW;Massie,BM;Icenogle,MV
为探讨充血性心力衰竭（CHF）患者骨骼肌对慢性运动的适应能力，对5例CHF患者进行了28 d的局部非优势腕屈肌训练。无机磷酸盐（Pi）和磷酸肌酸（PCr）进行了监测，在两个前臂在休息时，并在次最大的手腕屈曲运动在6，12，24和36 J.min-1之前和之后的运动训练。肢体血流量的同时测量体积描记法在12，24，和36 J.min-1。训练前后分别通过核磁共振成像和腕关节屈曲运动测量前臂肌肉质量和耐力。根据测量的Pi和PCr计算Pi/PCr比和pH。运动心输出量，心率，血浆去甲肾上腺素和乳酸在训练期间测得的不高于静息值，确认培训是本地化的前臂屈肌。训练后，肌肉生物能量学，评估的回归线的斜率相关的Pi/PCr次最大的工作量，改善了训练的前臂的每个病人，虽然肌肉质量，肢体血流量，和pH值不变。训练后前臂耐力增加了260%以上。在占主导地位的未经训练的前臂，没有一个测量的指标受到影响。我们的结论是，局部前臂运动训练CHF患者改善肌肉能量在次最大工作负荷的训练肌肉，这是独立的肌肉质量，肢体血流量，或在训练过程中的中枢心血管反应的影响。这些发现表明，CHF患者的外周肌肉代谢和功能异常可以得到改善，而不会改变心脏功能。图片
To examine the ability of the skeletal muscle of congestive heart failure (CHF) patients to adapt to chronic exercise, five patients performed localized nondominant wrist flexor training for 28 d. Inorganic phosphate (Pi) and phosphocreatine (PCr) were monitored by magnetic resonance spectroscopy in both forearms at rest and during submaximal wrist flexion exercise at 6, 12, 24, and 36 J.min-1 before and after exercise training. Simultaneous measurements of limb blood flow were made by plethysmography at 12, 24, and 36 J.min-1. Forearm muscle mass and endurance were measured by magnetic resonance imaging and wrist flexion exercise before and after training. The Pi/PCr ratio and pH were calculated from the measured Pi and PCr. Exercise cardiac output, heart rate, plasma norepinephrine, and lactate measured during training were not elevated above resting values, confirming that training was localized to the forearm flexor muscles. After training, muscle bioenergetics, as assessed by the slope of the regression line relating Pi/PCr to submaximal workloads, were improved in the trained forearm of each patient, although muscle mass, limb blood flow, and pH were unchanged. Forearm endurance increased by greater than 260% after training. In the dominant untrained forearm, none of the measured indices were affected. We conclude that localized forearm exercise training in CHF patients improves muscle energetics at submaximal workloads in the trained muscle, an effect which is independent of muscle mass, limb blood flow, or a central cardiovascular response during training. These findings indicate that peripheral muscle metabolic and functional abnormalities in CHF can be improved without altering cardiac performance.Images