Soothing the sleeping giant: Improving skeletal muscle oxygen kinetics and exercise intolerance in HFpEF

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Patients with heart failure with preserved ejection fraction (HFpEF) have similar degrees of exercise intolerance and dyspnea as patients with heart failure with reduced EF (HFrEF). The underlying pathophysiology leading to impaired exertional ability in the HFpEF syndrome is not completely understood, and a growing body of evidence suggests "peripheral," i.e., noncardiac, factors may play an important role. Changes in skeletal muscle function (decreased muscle mass, capillary density, mitochondrial volume, and phosphorylative capacity) are common findings in HFrEF. While cardiac failure and decreased cardiac reserve account for a large proportion of the decline in oxygen consumption in HFrEF, impaired oxygen diffusion and decreased skeletal muscle oxidative capacity can also hinder aerobic performance, functional capacity and oxygen consumption (VO<inf>2</inf>) kinetics. The impact of skeletal muscle dysfunction and abnormal oxidative capacity may be even more pronounced in HFpEF, a disease predominantly affecting the elderly and women, two demographic groups with a high prevalence of sarcopenia. In this review, we 1) describe the basic concepts of skeletal muscle oxygen kinetics and 2) evaluate evidence suggesting limitations in aerobic performance and functional capacity in HFpEF subjects may, in part, be due to alterations in skeletal muscle oxygen delivery and utilization. Improving oxygen kinetics with specific training regimens may improve exercise efficiency and reduce the tremendous burden imposed by skeletal muscle upon the cardiovascular system.

Original languageEnglish (US)
Pages (from-to)734-738
Number of pages5
JournalJournal of Applied Physiology
Volume119
Issue number6
DOIs
StatePublished - Sep 15 2015

Keywords

  • Exercise
  • Heart failure
  • Oxygen kinetics
  • Skeletal muscle

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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