Abnormal skeletal muscle bioenergetics during exercise in patients with heart failure: role of reduced muscle blood flow.

摘要: Using phosphorous nuclear magnetic resonance, we have previously demonstrated that patients with heart failure often exhibit abnormal forearm muscle metabolism during exercise. To determine if this altered is due to reduced flow, measured blood flow plethysmography and inorganic phosphate (Pi), phosphocreatine (PCr), pH 31P resonance spectroscopy at rest mild exercise (0.2, 0.4, 0.6 W) in 21 men 12 age-matched normal male subjects. The Pi/PCr ratio was correlated power output the slope of relationship used as an index metabolism. At rest, both groups had similar ratios (normal subjects 0.11 +/- 0.05; 0.03; p = NS) flows 2.9 1.4 ml/min/100 ml; 2.6 1.2 NS). In groups, resulted a progressive increase increased. However, exhibited steeper Pi/PCr-to-power than did U/W; 3.0 2.4 less .03). contrast, (at 0.2 W, 6.3 3.3 6.8 3.2 ml failure, respectively; 0.4 8.7 6.5 8.3 3.3; 12.8 7.9 12.0 4.6; all Nine slopes above range. These nine also comparable observed data indicate subpopulation failure. This metabolic alteration does not appear be decreased suggesting other mechanisms, such alterations mitochondrial population or substrate utilization, may responsible.