Skeletal muscle composition and its relation to exercise intolerance in older patients with heart failure and preserved ejection fraction.
Skeletal muscle composition and its relation to exercise intolerance in older patients with heart failure and preserved ejection fraction.
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DOI：
10.1016/j.amjcard.2013.12.031
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发表时间：
2014-04-01
影响因子：
2.8
通讯作者：
Kitzman, Dalane W.
中科院分区：
文献类型：
--
作者：
Haykowsky, Mark J.;Kouba, Erik J.;Brubaker, Peter H.;Nicklas, Barbara J.;Eggebeen, Joel;Kitzman, Dalane W.
运动不耐受是保留射血分数心力衰竭（HFpEF）的主要慢性症状，HFpEF是老年患者中最常见的心衰形式，但其病理生理机制尚不清楚。最近的数据表明，周围因素，如骨骼肌功能障碍，可能是重要的贡献者。因此，38名参与者，23名HFpEF患者（69±7岁）和15名年龄匹配的健康对照（HC），接受了磁共振成像和心肺运动测试，以评估：骨骼肌（SM），肌间脂肪（IMF），皮下脂肪（SCF），总大腿和大腿间室面积（TC）和峰值运动耗氧量（峰值VO2）。总大腿面积、TC、SCF或SM组间无显著差异。而HFpEF组与HC组相比，IMF面积（35.6±11.5 vs. 22.3±7.6 cm2, p=0.01）、IMF/TC比例（26±5 vs. 20±5%,p=0.005）、IMF/SM比例（0.38±0.10 vs. 0.28±0.09,p=0.007）显著增加，SM/TC比例（70±5 vs. 75±5,p=0.009）显著降低。在多变量分析中，IMF面积（偏r= -0.51, p=0.002）和IMF/SM比（偏r= -0.45, p=0.006）是VO2峰值的独立预测因子，而SM面积不是（偏r=-0.14, p=0.43）。因此，与HC相比，老年HFpEF患者的大腿IMF和IMF/SM比值更大，这与他们的峰值VO2严重降低有显著关系。这些数据表明，骨骼肌组成的异常可能导致老年HFpEF患者运动能力严重下降。这暗示了针对这种常见的老年人衰弱性疾病的新治疗策略的潜在目标。
Exercise intolerance is the primary chronic symptom in heart failure with preserved ejection fraction (HFpEF), the most common form of HF in older patients, however its pathophysiology is not well understood. Recent data suggest that peripheral factors, such as skeletal muscle dysfunction, may be important contributors. Therefore, 38 participants, 23 HFpEF patients (69±7 years) and 15 age-matched healthy controls (HC), underwent magnetic resonance imaging and cardiopulmonary exercise testing to assess for: skeletal muscle (SM), intermuscular fat (IMF), subcutaneous fat (SCF), total thigh, and thigh compartment areas (TC) and peak exercise oxygen consumption (peak VO2). There were no significant inter-group differences in total thigh area, TC, SCF, or SM. However, in HFpEF versus HC, IMF area (35.6±11.5 vs. 22.3±7.6 cm2, p=0.01), percent IMF/TC (26±5 vs. 20±5%, p=0.005), and the ratio of IMF/SM (0.38±0.10 vs. 0.28±0.09, p=0.007) were significantly increased, while percent SM/TC was significantly reduced (70±5 vs. 75 ±5, p=0.009). In multivariate analyses, IMF area (partial r= -0.51, p=0.002) and IMF/SM ratio (partial r= -0.45, p=0.006) were independent predictors of peak VO2 while SM area was not (partial r=-0.14, p=0.43). Thus, older HFpEF patients have greater thigh IMF and IMF/SM ratio compared to HC, and these are significantly related to their severely reduced peak VO2. These data suggest that abnormalities in skeletal muscle composition may contribute to the severely reduced exercise capacity in older HFpEF patients. This implicates potential targets for novel therapeutic strategies in this common, debilitating disorder of older persons.
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影响因子：
15.8
作者：
Civitarese AE;Carling S;Heilbronn LK;Hulver MH;Ukropcova B;Deutsch WA;Smith SR;Ravussin E;CALERIE Pennington Team
通讯作者：
CALERIE Pennington Team
DOI：
10.1161/circheartfailure.110.958785
发表时间：
2010-11
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Kitzman DW;Brubaker PH;Morgan TM;Stewart KP;Little WC
通讯作者：
Little WC
影响因子：
24
作者：
Haykowsky, Mark J.;Brubaker, Peter H.;Stewart, Kathryn P.;Morgan, Timothy M.;Eggebeen, Joel;Kitzman, Dalane W.
通讯作者：
Kitzman, Dalane W.
影响因子：
18.2
作者：
Bhella, Paul S.;Prasad, Anand;Levine, Benjamin D.
通讯作者：
Levine, Benjamin D.
DOI：
10.1093/gerona/glt011
发表时间：
2013-08-01
影响因子：
5.1
作者：
Haykowsky, Mark J.;Brubaker, Peter H.;Kitzman, Dalane W.
通讯作者：
Kitzman, Dalane W.