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Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations.

Publication ,  Journal Article
Duscha, BD; Kraus, WE; Keteyian, SJ; Sullivan, MJ; Green, HJ; Schachat, FH; Pippen, AM; Brawner, CA; Blank, JM; Annex, BH
Published in: J Am Coll Cardiol
June 1999

OBJECTIVES: The study was conducted to determine if the capillary density of skeletal muscle is a potential contributor to exercise intolerance in class II-III chronic heart failure (CHF). BACKGROUND: Previous studies suggest that abnormalities in skeletal muscle histology, contractile protein content and enzymology contribute to exercise intolerance in CHF. METHODS: The present study examined skeletal muscle biopsies from 22 male patients with CHF compared with 10 age-matched normal male control patients. Aerobic capacities, myosin heavy chain (MHC) isoforms, enzymes, and capillary density were measured. RESULTS: The patients with CHF demonstrated a reduced peak oxygen consumption when compared to controls (15.0+/-2.5 vs. 19.8+/-5.0 ml x kg(-1) x min(-1), p <0.05). Using cell-specific antibodies to directly assess vascular density, there was a reduction in capillary density in CHF measured as the number of endothelial cells/fiber (1.42+/-0.28 vs. 1.74+/-0.35, p = 0.02). In CHF, capillary density was inversely related to maximal oxygen consumption (r = 0.479, p = 0.02). The MHC IIx isoform was found to be higher in patients with CHF versus normal subjects (28.5+/-13.6 vs. 19.5+/-9.4, p <0.05). CONCLUSIONS: There was a significant reduction in microvascular density in patients with CHF compared with the control group, without major differences in other usual histologic and biochemical aerobic markers. The inverse relationship with peak oxygen consumption seen in the CHF group suggests that a reduction in microvascular density of skeletal muscle may precede other skeletal muscle alterations and play a critical role in the exercise intolerance characteristic of patients with CHF.

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 1999

Volume

33

Issue

7

Start / End Page

1956 / 1963

Location

United States

Related Subject Headings

  • Stroke Volume
  • Prognosis
  • Oxygen Consumption
  • Muscle, Skeletal
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Gated Blood-Pool Imaging
  • Exercise Tolerance
 

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Duscha, B. D., Kraus, W. E., Keteyian, S. J., Sullivan, M. J., Green, H. J., Schachat, F. H., … Annex, B. H. (1999). Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol, 33(7), 1956–1963. https://doi.org/10.1016/s0735-1097(99)00101-1
Duscha, B. D., W. E. Kraus, S. J. Keteyian, M. J. Sullivan, H. J. Green, F. H. Schachat, A. M. Pippen, C. A. Brawner, J. M. Blank, and B. H. Annex. “Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations.J Am Coll Cardiol 33, no. 7 (June 1999): 1956–63. https://doi.org/10.1016/s0735-1097(99)00101-1.
Duscha BD, Kraus WE, Keteyian SJ, Sullivan MJ, Green HJ, Schachat FH, et al. Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol. 1999 Jun;33(7):1956–63.
Duscha, B. D., et al. “Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations.J Am Coll Cardiol, vol. 33, no. 7, June 1999, pp. 1956–63. Pubmed, doi:10.1016/s0735-1097(99)00101-1.
Duscha BD, Kraus WE, Keteyian SJ, Sullivan MJ, Green HJ, Schachat FH, Pippen AM, Brawner CA, Blank JM, Annex BH. Capillary density of skeletal muscle: a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol. 1999 Jun;33(7):1956–1963.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 1999

Volume

33

Issue

7

Start / End Page

1956 / 1963

Location

United States

Related Subject Headings

  • Stroke Volume
  • Prognosis
  • Oxygen Consumption
  • Muscle, Skeletal
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Gated Blood-Pool Imaging
  • Exercise Tolerance